Method and apparatus for loading suture

ABSTRACT

A loader is disclosed that can load a suture and/or a shuttle into a suture device. The loader can have a suture and/or a shuttle that can be moved (e.g., via a loader control) from a non-loaded configuration to a loaded configuration without damaging the suture or the shuttle. The shuttle can be moved from a shuttle first position to a shuttle second position. When the shuttle is in the shuttle first position, a suture device can be positionable in a device space on the loader. When the suture device is positioned in the device space, the shuttle can be moved from the shuttle first position to the shuttle second position. When the shuttle is in the shuttle first position, the shuttle can be outside the suture device. When the shuttle is in the shuttle second position, the shuttle can be inside the suture device.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.16/734,406 filed Jan. 6, 2020, which is incorporated herein by referencein its entirety for all purposes.

BACKGROUND 1. Technical Field

The present disclosure relates to systems, methods, and devices forloading suture and/or shuttles into suture devices (also referred to assuture manipulating devices).

2. Description of Related Art

Suture devices can pass suture and/or shuttles through tissue but mayneed to be loaded with suture and/or a shuttle before use.

A need still exists to load suture and/or shuttles into suture deviceswithout damaging the suture and/or the shuttle during the loadingprocess.

SUMMARY

This disclosure relates generally to suture devices and methods ofloading the same.

Suture device loaders are disclosed. For example, a suture device loaderis disclosed that can have a body. The body can have a device space. Thesuture device loader can have a shuttle. The shuttle can be moveablefrom a shuttle first position to a shuttle second position. When theshuttle is in the shuttle first position, a suture device can bepositionable in the device space. When the suture device is positionedin the device space, the shuttle can be moveable from the shuttle firstposition to the shuttle second position. When the shuttle is in theshuttle first position, the shuttle can be outside the suture device.When the shuttle is in the shuttle second position, the shuttle can beinside the suture device.

Suture device loaders are disclosed. For example, a suture device loaderis disclosed that can have a body. The body can have a device space. Thesuture device loader can have a suture. The suture can be moveable froma suture first position to a suture second position. When the suture isin the suture first position, a suture device is positionable in thedevice space. When the suture device is positioned in the device space,the suture can be moveable from the suture first position to the suturesecond position. More of the suture can be in the suture device when thesuture is in the suture second position than when the suture is in thesuture first position.

Methods of loading suture devices are disclosed. For example, a methodof loading a suture device is disclosed that can include removablyattaching the suture device to a loader. The loader can have a loadercontrol, a suture, and a shuttle. The method can include loading, viathe loader control, the shuttle and the suture into the suture device.Loading can comprise moving, via the loader control, the shuttle and thesuture from a non-loaded configuration to a loaded configuration bymoving the loader control from a loader control first position to aloader control second position. When the loader control is in the loadercontrol first position, the shuttle and the suture can be in thenon-loaded configuration. When the loader control is in the loadercontrol second position, the shuttle and the suture can be in the loadedconfiguration.

BRIEF DESCRIPTION OF THE FIGURES

The drawings shown and described are exemplary embodiments andnon-limiting. Like reference numerals indicate identical or functionallyequivalent features throughout.

FIGS. 1a, 1b and 1c are perspective, top and side views, respectively,of a variation of the suture passing device.

FIGS. 2a and 2b are a distant and close-up view, respectively, of avariation of the shuttle in a straight configuration.

FIG. 2c is a close-up view of the variation of the shuttle from FIGS. 2aand 2b in a curved configuration.

FIG. 3a is a close-up, perspective, partial see-through view of thedistal end of a variation of the suture passing device attached to alength of a suture.

FIG. 3b is a close-up view of a portion of FIG. 3 a.

FIGS. 4a and 4b are close-up perspective and side views, respectively,of the distal end of a variation of the suture passing device in aclosed configuration.

FIG. 4c is a close-up of the distal end of FIGS. 4a and 4 b.

FIG. 4d is a close-up perspective view of the distal end of the deviceof FIG. 4a in a closed configuration.

FIGS. 5A and 5B illustrate variations of the shuttle.

FIGS. 6A through 6F are bottom and side perspective, partial see-through(the upper jaw is see-through), longitudinal cross-section, partialcut-away close-up, and partial cut-away views, respectively, of thedistal end of a variation of the device with the jaws in an openedconfiguration with the shuttle and pushers in various positions, andwith the compression cover not shown in FIG. 6F for illustrativepurposes.

FIG. 7A is a side perspective view of a variation of the distal end ofdevice with the jaws in a closed configuration with the shuttle in theupper jaw and not engaged in the lower jaw.

FIGS. 7B and 7C are longitudinal cross-section and side perspectiveviews, respectively, of the device of FIG. 7A with the shuttle in thetop and bottom jaws. FIG. 26 b does not show the pushers forillustrative purposes.

FIG. 7D is a partial cut-away view of FIG. 7C.

FIG. 8A illustrates a variation of the shuttle in a lower jaw with halfthe lower jaw shown transparent.

FIG. 8B illustrates a variation of the shuttle in a lower jaw with halfthe lower jaw shown transparent.

FIG. 9A illustrates a variation of the shuttle in an upper jaw with halfthe upper jaw shown transparent.

FIG. 9B illustrates a variation of the shuttle in an upper jaw with halfthe upper jaw shown transparent.

FIG. 10 illustrates a variation of the device with half the lower andupper jaws shown transparent.

FIG. 11A illustrates a perspective view of a variation of a shuttle.

FIG. 11B illustrates a bottom view of the shuttle of FIG. 11A.

FIG. 11C illustrates a side view of the shuttle of FIG. 11A.

FIG. 12A illustrates a side view of a variation of the device with halfthe device shown transparent.

FIG. 12B illustrates a perspective view of the device of FIG. 12A.

FIG. 13A illustrates a variation of the device.

FIG. 13B illustrates a variation of the device.

FIG. 13C illustrates a variation of a handle of the device.

FIG. 13D illustrates a variation of a handle of the device.

FIG. 13E illustrates a variation of a handle of the device.

FIG. 14A illustrates a top view of a variation of a loader.

FIG. 14B illustrates a top view of a variation of a loader.

FIG. 14C illustrates a top view of a variation of a loader.

FIG. 14D illustrates a perspective view of a variation of a loader.

FIG. 14E illustrates a top view of a variation of a loader.

FIG. 14F illustrates a perspective view of a variation of a loader.

FIG. 15A illustrates a top view of a variation of a loader.

FIG. 15B illustrates a perspective view of a variation of a loader.

FIG. 15C illustrates a magnified perspective view of the loader of FIG.15B.

FIG. 15D illustrates a magnified perspective view of the loader of FIG.15C.

FIG. 15E illustrates a magnified perspective cross-sectional view of theloader of FIG. 15D.

FIG. 15F illustrates a magnified perspective cross-sectional view of theloader of FIG. 15C.

FIG. 16 illustrates a top view of a variation of a loader.

FIG. 17A illustrates a top view of a variation of a loader.

FIG. 17B is a magnified view of the loader of FIG. 17A at section17B-17B.

FIG. 17C is a perspective view of FIG. 17B.

FIG. 18 is a bottom view of a variation of a loader.

FIG. 19A is a perspective view of a variation of a loader control.

FIG. 19B is a perspective view of a variation of a loader control.

DETAILED DESCRIPTION

FIGS. 1a through 1c illustrate a suture passing device 188 that can beused to pass suture 70 through soft or hard tissue 74 with or withoutremoving the device 188 or the suture 70 from the target site whilecreating one or more complete stitches.

The suture passing device 188 can have an ergonomic handle 104, asliding tube actuator 6, and a distal end 2. The ergonomic handle 104can be used to control the distal end 2. The ergonomic handle 104 canhave a side knob 10. The ergonomic handle 104 can have a top knob 12.The top knob 12 and/or the side knob 10 can individually or in concert,advance and/or retract the upper 86 and/or lower pusher 76.

The sliding tube actuator 6 can have an outer compression cover 34 andan inner rod (not shown due to obstruction by the outer compressioncover 34). The inner rod can be fixedly attached to the handle 104 andthe proximal end of the jaw structure 28. The outer compression cover 34can be radially outside of the inner rod. The outer compression cover 34can be actuated by the handle 104, for example be distally andproximally translated with respect to the handle 104 when the trigger 8is squeezed or released.

FIGS. 2a and 2b illustrate that the device 188 can have a sliding ribbonshuttle 14 or needle held within the device 188. The shuttle 14 can havean elongated shuttle rail 16. The shuttle rail 16 can have numerousslits 20 along one or both sides of the shuttle rail 16. The slits 20can be positioned at regular or irregular length intervals along therail 16.

The shuttle 14 can have a suture holder 18 extending laterally from therail 16. The shuttle 14, for example the suture holder 18, can extendout of the lateral side slot 72 of the arm structure. The suture holder18 can extend from the left and/or right side of the device 188. Thedistal end 2 of the device 188 can be reversible so the suture holder 18can be switched from one side of the device 188 to the other side of thedevice 188. The suture holder 18 can have a generally flat, isoscelestrapezoid configuration. The suture holder 18 can have a suture holdingnotch 100. The notch 100 can have an inner hole 17 a, an outer hole 17 bcontiguous with the inner hole 17 a, and a first cleat 97 a positionedbetween the inner hole 17 a and the outer hole 17 b. The notch 100 canhave a second cleat 97 b on the side of the outer hole away from theinner hole. The notch 100 can be configured to secure to suture 70. Forexample, the suture 70 can be compressed and friction fit in the innercleat 97 a.

The suture holder 18 can have a front leading edge and a rear leadingedge. The edges can be slanted at a right or non-right angle withrespect to the longitudinal axis of the rail 16. One or both of theedges can be sharpened to be traumatic to tissue 74, for example to cutthrough soft tissue 74. The edges can cut through tissue 74, allowingthe suture holder 18 to pull the suture 70 through the tissue 74immediately behind the respective edge.

The shuttle 14 can be made from a flexible polymer, such as PEEK, aresilient metal such as Nitinol, any material disclosed herein orcombinations thereof. The shuttle 14 can be made from a molded polymer.The shuttle 14 can be pre-curved, for example to reduce resistance whengoing around curves in the tracks.

FIG. 2c illustrates that the rail 16 can curve at the locations of theslits 20, and/or the rail 16 can be pre-curved.

FIGS. 3a and 3b illustrate that the suture passing device 188 cancapture or releasably attach to the suture 70 in the inner and/or outercleats 97 a and/or 97 b of the suture holder 18. The suture 70 can beloaded or held laterally of the jaw structure 28, out of plane with therotation of the jaws. The device 188 can make multiple passes of thesuture 70 through the tissue 74 without extracting or reloading thesuture passing device 188. The jaw structure 28 can resiliently deformopen at the proximal end of the jaw structure 28, having no hinge. Thejaws can be opened and/or closed with no mechanical pivots or linkagesin the jaw structure 28.

FIG. 4a illustrates that the suture passer device 188 can have a jawstructure 28 with a top jaw 30 and a bottom jaw 38. The entire jawstructure 28 can be an integral piece of material, such as a singlemolded, cast, or cut element of Nitinol, other resilient metal orpolymer, any other material listed herein, or combinations thereof. Thejaw structure 28 can be configured to be in an opened configuration (asshown in FIG. 4d ) when in an unbiased configuration (i.e., when noexternal forces are applied).

The jaw structure 28 can have a jaw structure longitudinal axis 42. Eachjaw can also have a respective jaw longitudinal axis along the jaw.

The inside channel of the compression cover 34 can be sized and shapedto fit over the jaw structure 28 with minimum clearance when the jawstructure 28 is in a closed configuration. When the compression cover istranslated distally 138 with respect to the jaw structure 28, as shownby arrow, the compression cover 34 can press the top and bottom jaws 38toward the jaw structure longitudinal axis 42. The jaw structure 28 canbe fully compressed into a closed configuration, as shown in FIGS. 4athrough 4c . In this way, when an actuation lever such as the trigger 8is actuated, the channel or compression cover 34 can advance to camclosed the jaws. The jaws can pre-pierce the tissue and establish acontinuous track for the shuttle to pass through the tissue.

The compression cover 34 can be attached to an opening ball 32positioned between the first and second jaws.

FIG. 4b illustrates that the opening ball 32 can be rotatably or fixedlyattached to a ball axle 52 passing laterally through the opening ball32. The ball axle 52 can extend out from the lateral sides of the ball32. The ball axle 52 can be slidably received by axle slots 50 formedthrough distal arms 54 or extensions 138 of the compression cover 34.When the jaw structure 28 is in a closed configuration, the ball axle 52can abut and interference fit against the proximal end of the axle slot50, for example to prevent overextension of the compression cover 34over the jaw structure 28. When the jaw structure 28 is in an openedconfiguration, the ball axle 52 can abut and interference fit againstthe distal end 2 of the axle slot 50, for example to preventoverrotation of the jaws and/or pulling the ball 32 past the ramps 44 onthe inside of the jaw structure 28.

FIG. 4c illustrates that the bottom track 66 can distally terminate in abottom track port 62. The top track 64 can distally terminate at a toptrack port 60. The top track port 60 can align with and be adjacent to(as shown) or in contact with the bottom track port 62 when the jawstructure 28 is in a closed configuration with the first jaw tip 46interdigitating with the second jaw tip 48. The tracks of the upper jaw78 and bottom jaw 38 can form a continuous path when the jaw structure28 is in a closed configuration. The first jaw tip 46 can interdigitatewith and be adjacent or in contact with the second jaw tip 48 when thejaw structure 28 is in a closed configuration.

FIG. 4d illustrates that that compression cover 34 can be translatedproximally 126, as shown by arrow, with respect to the jaw structure 28.The ball axle 52 can slide to the distal end 2 of the axle slot 50. Theaxle slot 50 can then pull the ball axle 52, and therefore the openingball 32, proximally. The opening ball 32 can then press against theinside surface ramp 44 of the first jaw and/or second jaw. The first jawtip 46 and/or second jaw tip 48 can then rotate away from the opposingjaw tip. The jaw structure 28 can then be in an opened configuration, asshown.

The proximal ends of the jaws can be rigid or flexible, for example tobend around the opening of the compression cover 34 when the jaws are inan opened configuration. The entire jaws or just the proximal ends ofthe jaws can be made from Nitinol, for example with the distal ends ofthe jaws made from stainless steel.

FIG. 5A illustrates that the suture holder 18 can be an arc integralwith the shuttle spine 160. For example, the shuttle 14 can be made froma single panel of material (e.g., metal). The lateral sides of thesuture holder 18 can be cut, and the longitudinal ends can remainintegrated with the shuttle spine 160. The suture holder 18 can then bebent or otherwise deformed away from the plane of the shuttle spine 160,for example forming an arc away from the plane of the shuttle spine 160.

The suture 70 can have a suture loop 162 at the terminal end of thesuture 70. The suture loop 162 can extend around and completely orpartially circumscribe the suture holder 18. The remainder of the suture70 can be integral with the suture loop 162, or can removably attachedto the suture loop 162. The suture loop 162 can be circular or oval.

FIG. 5B illustrates that the shuttle 14 can have one or more shuttlenotches 166 or cut-outs. For example, the shuttle 14 can have twoshuttle notches 166 on each lateral site of the shuttle. The shuttlenotches 166 can be even longitudinally spaced and distributed along theshuttle 14. The shuttle notches 166 can be curved. The sides of theshuttle 14, other than at the notches, can be straight.

A radius of curvature of the shuttle notch 166 can be from about 1 mm toabout 2 mm.

FIGS. 6A through 6F illustrate that the upper jaw tip 206 and/or lowerjaw tip 198 can have suture holder slots 238. The suture holder slots238 can extend medially along the outer surface of the respective jawtip. The suture holder slot 238 can extend from the outer surface of thejaw tip to the respective track. The suture holder 18 can be accessiblethrough or extend out of the suture holder slot 238. The suture 70 (notshown) can attach to or be integral with the suture holder 18 in oroutside of the suture holder slot 238.

The upper track 264 can distally terminate at an upper jaw tip shuttleport 240. The lower track 148 can distally terminate at a lower jaw tipshuttle port 256. The shuttle 14 can extend out of or into, and passthrough each of the shuttle 14 ports. During use, the sharpened shuttletip 164 extending out of the shuttle port can pierce, cut and dissecttissue 74 when the jaws are rotated to a closed configuration.

The upper jaw 78 and/or lower jaw 80 can have a jaw stop 242. The jawstop 242 can be a feature, shape or configuration that can abut and stopthe distal translation of the compression cover 34 with respect to thejaws. For example, the distal terminal end of the compression cover 34can abut the jaw stops 242 when the jaws are in a closed configuration.

The radially inner surface of the jaws can have radially inner slopes250.

The upper jaw 78 and/or lower jaw 80 can have a jaw slide 244. The jawslide 244 can be a radially outer surface of the jaws between the jawstops 242 and the compression cover 34 when the compression cover 34 isin a proximally retracted 126 position with respect to the jaws and/orthe jaws are in an opened configuration. The jaw slide 244 can increasein radius from the jaw structure longitudinal axis 42 in the distallongitudinal direction (e.g., the larger the longitudinal dimension ofthe jaw slide 244, the larger the radial dimension of the jaw slide244). When the compression cover is translated distally 138 with respectto the jaws, the radially inner distal edge of the compression cover 34can slide along the jaw slide 244, and press the jaw slide 244 towardthe jaw structure longitudinal axis 42. A radially compressive forcedelivered from the compression cover 34 to the jaw slide 244 can createa torque in the respective jaw, rotating the respective jaw toward thejaw structure longitudinal axis 42 and the opposing jaw.

The device 188 can have a jaw control extension 40. The jaw controlextension 40 can extend along the jaw structure longitudinal axis 42.The jaw control extension 40 can extend between the jaws proximal to thejaw tips. The jaw control extensions 40 can terminate in a jaw controlextension head 254.

The jaw control extension head 254 can have one or two lobes or cams.Each lobe can extend from the longitudinal axis of the jaw controlextension 40 toward a jaw. The lobes can act similarly to the openingroller ball shown in FIGS. 4a, 4d , and elsewhere herein. The upper jaw78 and lower jaw 80 can have upper and inner jaw radially inner slopes250, respectively. The inner slopes can be the radially inner surfacesof the jaws proximal to the jaw tips and distal to the jaw controlextension head 254 when the jaw control extension head 254 is in aproximally retracted position with respect to the jaws. The radiallyinner slope 250 can increase in radius from the jaw structurelongitudinal axis 42 in the distal longitudinal direction (e.g., thelarger the longitudinal dimension of the radially inner slope 250, thelarger the radial dimension of the radially inner slope 250). When thejaw control extension 40 is proximally translated or retracted withrespect to the jaws, the lobes can slide against the radially innerslopes 250 of the jaws and press the jaws away from each other into anopen configuration.

When the jaws are in an open configuration, the compression cover 34 canbe positioned at or proximally past the proximal end of the jaw slides244, and the jaw extension head can be positioned at or proximally pastthe proximal end of the radially inner slopes 250.

The jaw control extension 40 can be attached to or integral with acontrol rail 248. The control rail 248 can extend radially from one orboth lateral sides of the jaw control extension 40, for example in aplane at a right angle to a plane defined by the opposing jaws or theopposing extension head lobes 252.

The compression cover 34 can have a control rail slot 246. The controlrail slot 246 can extend to the distal terminal end of the compressioncover 34. The control rail 248 can be fixed to or longitudinallytranslate within the control rail slot 246. The control rail 248 caninterference fit, abut or stop against the proximal end of the controlrail slot 246, for example when the control rail 248 is in a proximal ordistal longitudinal position with respect to the jaws. The control rail248 can move longitudinally in unison (i.e., coincidentally) with thecompression cover 34 in the distal and/or longitudinal directions. Thecontrol rail 248 can move longitudinally in unison with the jaw controlextension 40 in the distal and/or longitudinal directions.

The device 188 can have an upper socket arm 258 and a lower socket arm270 radially inside of the compression cover 34. The upper socket arm258 and lower socket arm 270 can be a single integrated element (e.g., ahollow cylinder) or separate elements. The upper socket arm 258 can beopposite the lower socket arm 270. The upper socket arm 258 can betranslatably fixed (i.e., mechanically attached to translate in unison)to the lower socket arm 270. The jaw control extension 40 can extendlongitudinally between the upper 258 and lower socket arms 270 or withina hollow channel inside a unitary socket arm (comprising the upper 258and lower socket arms 270 as an integrated element). The distal terminalends of the socket arms can extend to or proximal to the distal terminalend of the compression cover 34 when the jaws are in an openconfiguration.

The proximal terminal end of the upper jaw 78 can have a laterallyelongated upper jaw bearing 262. The upper jaw bearing 262 can extendradially outward from the remainder for the proximal end of the upperjaw 78.

The distal end 2 of the upper socket arm 258 can have a laterallyelongated upper jaw socket 260. The upper jaw socket 260 can openmedially and have a diameter approximately equal to or slightly largerthan the diameter of the upper jaw bearing 262.

An upper jaw 78 hinge can have the upper jaw bearing 262 and the upperjaw socket 260. The upper jaw 78 can rotate around the transverse axisof the upper jaw bearing 262. The upper jaw bearing 262 can rotate inthe upper jaw socket 260.

The proximal terminal end of the lower jaw 80 can have a laterallyelongated lower jaw bearing 266. The lower jaw bearing 266 can extendradially outward from the remainder for the proximal end of the lowerjaw 80.

The distal end 2 of the lower socket arm 270 can have a laterallyelongated lower jaw socket 268. The lower jaw socket 268 can openmedially and have a diameter approximately equal to or slightly largerthan the diameter of the lower jaw bearing 266.

A lower jaw 80 hinge can have the lower jaw bearing 266 and the lowerjaw socket 268. The lower jaw 80 can rotate around the transverse axisof the lower jaw bearing 266. The lower jaw bearing 266 can rotate inthe lower jaw socket 268.

The upper 86 and/or lower pushers 76 can have entire lengths or onlydistal ends 2 that can have articulated segmentations 286. Thearticulated segments 286 can rotate with respect to each other around anaxis perpendicular to the longitudinal axis of the respective pusher.The articulated segmentations 286 can be connected by a discrete hinge(e.g., a pin or snap connection) or can be longitudinally coincidentalor longitudinally alternating lateral slots cut into the sides of thepusher, similar to the shape of the shuttle lateral slots 158. Theproximal end of either or both upper 86 and lower pushers 76 can have acontinuous, non-segmented, flat, uniform ribbon of material.

Each of the upper 86 and/or lower pushers 76 can have distal terminalends that can have a shuttle seat 274. The shuttle seat 274 can be aninverse shape to the shape of the shuttle tip 164. For example, if theshuttle tip 164 has an angled end, the shuttle seat 274 can have theopposite angle. If the shuttle tip 164 has a convex curved end, theshuttle seat 274 can have a concave curved end with the same radius ofcurvature as the shuttle tip 164.

FIGS. 7A through 7D illustrate that the compression cover 34 can bedistally translated, as shown by arrow, with respect to the jaws. Thecompression cover 34 can deliver translational force through the edgesof the control rail slot 246 to the control rail 248. The control rail248 can deliver the translational force to the jaw control extension 40.The jaw control extension 40 can translate distally, as shown by arrow,concurrently with the compression cover 34. The compression cover 34 cantranslate 138 over the jaw slides 244, pressing radially inward on thejaw slides 244. The jaw control extension head 254 can move distallywith respect to the jaws, as shown by arrow 280, for example, allowingthe closure of the jaws without interference fitting or abutting againstthe jaw control extension head 254. The upper jaw 78 and/or lower jaw 80can rotate radially inward, as shown by arrows.

When the jaws are in a closed configuration, the compression cover 34can be positioned at or adjacent to the jaw stop 242, and the jawextension head can be positioned at or proximally past the proximal endof the radially inner slopes 250.

When the jaws are in a closed configuration, if the shuttle 14 is in theupper track 264, the upper pusher 86 can translate distally through theupper track 264. The distal terminal end of the upper pusher 86 can abutthe shuttle 14. The upper pusher 86 can then push the shuttle 14 throughthe upper track 264, out the upper jaw tip shuttle port 240 and into thelower jaw tip shuttle port 256.

When the jaws are in a closed configuration, if the shuttle 14 is in thelower track 148, the lower pusher 76 can translate distally through thelower track 148. The distal terminal end of the lower pusher 76 can abutthe shuttle 14. The lower pusher 76 can then push the shuttle 14 throughthe lower track 148, out the lower jaw tip shuttle port 256 and into theupper jaw tip shuttle port 240.

When the shuttle 14 is pushed from the upper track 264 to the lowertrack 148 or vice versa, the shuttle 14 can be curvilinearly translated282, as shown by arrow, following the paths of the upper track 264 andthe lower track 148.

When the jaws are in a closed configuration, the shuttle 14 can movefrom the upper jaw 78 to the lower jaw 80, as shown by arrow, back tothe upper jaw 78, and can repeat the motion from the upper jaw 78 to thelower jaw 80, and optionally from the lower jaw 80 to the upper jaw 78one, two or more times.

The device 188 can have a pusher lockout that can prevent translation ofthe pushers and the shuttle 14 when the jaws are in an openconfiguration.

The device 188 can have a jaw lockout preventing opening of the jawswhen either of the pushers is extended out of the respective jaw tipshuttle port and/or when the shuttle 14 is concurrently in the upper jaw78 and the lower jaw 80.

FIG. 8A illustrates that the suture holder 18 can be attached to orintegrated with the shuttle 14. For example, the suture holder 18 can bea bridge integrated with the shuttle spine 160. A portion of the shuttlespine 160 can define the suture holder 18. As another example, thesuture holder 18 can be removably attached to the shuttle 14. The sutureholder 18 can extend between a shuttle first lateral side and a shuttlesecond lateral side. The suture holder 18 can extend between a shuttlefirst longitudinal side and a shuttle second longitudinal side. Thesuture holder 18 can be in the longitudinal center of the shuttle 14, ona proximal end of the shuttle 14, or on a distal end of the shuttle 14.A center of the suture holder 18 can be in the transverse center of theshuttle 14, on a first lateral side of the shuttle, or on a secondlateral side of the shuttle. The suture holder 18 can be in the plane ofthe shuttle spine 160, extend away from the plane of the shuttle spine160, or both. For example, FIG. 8A illustrates that the suture holder 18does not extend away from the plane of the shuttle spine 160. The planeof the suture holder 18 can be flush with or coincident with the planeof the shuttle spine 160. This can advantageously allow the shuttle andsuture holder 14, 18 to take up less space, thereby minimizing thetrauma to surrounding tissue as the shuttle 14 is passed between theupper and lower jaws 30, 38 since it brings the base of the suture 70closer to the shuttle 14. With the suture 70 closer to the shuttle 14,the force of the suture 70 against surrounding tissue is reduced ascompared to when the suture 70 is connected to a structure out of theplane of the shuttle spine 160 (e.g., the suture holder 18 of FIGS. 5Aand 5B). The shuttle and suture holder 18 can be a monolithic structure.The suture loop 162 can extend around and completely or partiallycircumscribe the suture holder 18. The remainder of the suture 70 can beintegral with the suture loop 162, or can removably attached to thesuture loop 162. The suture loop 162 can be attached to or integratedwith the suture 70 at a suture junction 73. The suture junction 73 canbe a knot, a braid, or both. The suture loop 162 can be circular, oval,or stadium-shaped.

The shuttle 14 can have zero, one, or multiple suture holes 404, forexample, 0 to 4 or more suture holes 404, including every 1 suture holeincrement within this range. For example, FIG. 8A illustrates that theshuttle 14 can have a first suture hole 404 a and a second suture hole404 b. The shuttle holes 404 (e.g., first and second suture holes 404 a,404 b) can have a regular or irregular shape, for example, curved,polygonal, or both. The suture holes 404 can be defined by one or morecurved surfaces or curved edges, for example, one or more curvedsurfaces or curved edges of the shuttle 14. The suture holes 404 can bedefined by one or more flat surfaces or straight edges, for example, oneor more flat surfaces or straight edges of the shuttle 14. The sutureholes 404 can have a cross-sectional shape of a circle, ellipse,rectangle, stadium, horseshoe, star, slot, or any combination thereof.The suture holes 404 can have such cross sectional shapes when theshuttle is curved or flat. The suture holes 404 can have a constantcross-sectional area or a tapered cross-sectional area.

The shuttle tips 164 can be beveled, non-beveled, or both. For example,FIG. 8A illustrates that the shuttle tips 164 can be non-beveled. Theshuttle tips 164 can have one or multiple tip surfaces 406, for example,1 to 4 or more tip surfaces 406, including every 1 tip surface incrementwithin this range (e.g., 1 tip surface, 2 tip surfaces). For example,FIG. 8A illustrates that the shuttle tips 164 can have a first tipsurface 406 a (e.g., a first non-beveled tip surface as shown in FIG.8A) and a second tip surface 406 b (e.g., a second non-beveled tipsurface as shown in FIG. 8A). The non-beveled portion of the shuttletips 164 can advantageously improve the force transfer from the upperand lower pushers 86, 76, thereby making it easier for the pushers 86and 76 to push against the shuttle 14. A larger component of the forcefrom the pushers (e.g., pushers 86 and 76) can be transferred along thelongitudinal axis of the shuttle 14 when the shuttle tip 164 has anon-beveled surface 406 as compared to a beveled surface (e.g., thebeveled surfaces shown in FIGS. 14a-14c ). For beveled surfaces, aportion of the force applied to the shuttle 14 is directed against thesurfaces that define the lower and upper tracks 66, 64 perpendicularlyaway from the beveled surface. When a pusher applies a longitudinalforce against a beveled surface, a portion of the longitudinal forceapplied to the shuttle 14 by the pusher is transformed into a transversecomponent away from the longitudinal axis of the shuttle 14.

FIG. 8A further illustrates that the shuttle tips 164 can be tapered toform a terminal tip 165. The terminal tip 165 can be an edge or part ofa rounded or flat surface. The tapered portion of the shuttle tip 164can be a first bevel, for example, a first transverse bevel toward alongitudinal axis (e.g., center longitudinal axis) of the shuttle 14.The non-beveled surfaces 406 can thereby form first tissue cuttingsurfaces that are beveled in a first direction. The bevel referred to inthe preceding paragraph can refer to a second bevel, for example, asecond transverse bevel angled relative to a transverse axisperpendicular to the transverse axis of the first bevel and toward alongitudinal axis (e.g., center longitudinal axis) of the shuttle 14.Such a second bevel is shown in FIGS. 14a-14c . The second bevels candefine second beveled surfaces along the taper that face a seconddirection different from the first direction. The second bevels can formsecond tissue cutting surfaces. The shuttle tips 164 can pierce or cuttissue. The tapered portion of the shuttle tips 164 can pierce or cuttissue. The tip surfaces 406 (e.g., tip surfaces 406 a and 406 b) canpierce or cut tissue. When the shuttle tips 164 have first and secondbevels, the first and second bevels can pierce tissue or cut tissue.FIG. 8A illustrates that the shuttle tips 164 can be non-sharpened,meaning that while the edges are tapered to form a first cuttingsurface, the cutting surfaces 406 themselves can be chamfered ornon-chamfered. The shuttle tips 164 can be non-sharpened and still cutor pierce tissue, where sharpened or non-sharpened can refer to thepresence or non-presence of a second bevel (e.g., as shown in FIGS.14a-14c ), respectively.

FIG. 8A further illustrates that the device 188 can have one or multiplemale stops 412 (also referred to as male catches, male detents, stops,catchers, detents) and one or multiple female stops 416 (also referredto as female catches, female detents, stops, catchers, detents). Thedevice 188 can have, for example, 1-10 or more male stops 412, includingevery 1 male stop increment within this range (e.g., 1, 2, 3, 4 or moremale stops). The device 188 can have, for example, 1-10 or more femalestops 416, including every 1 female stop increment within this range(e.g., 1, 2, 3, 4 or more female stops).

The male stops 412 can be attached to or integrated with the device 188.For example, the male stops 412 can be part of, attached to, orintegrated with the shuttle 14. As another example, the male stops 412can be part of, attached to, or integrated with the jaws (e.g., jaws 30,38, 78, 80). As yet another example, the device 188 can have some malestops 412 that are part of, attached to, or integrated with the shuttle14 and can have some male stops 412 that are part of, attached to, orintegrated with the jaws (e.g., jaws 330, 38, 78, 80). As yet stillanother example, the male stops 412 can be part of, attached to, orintegrated with the pushers (e.g., the lower and upper pushers 76, 86).

The female stops 416 can be attached to or integrated with the device188. For example, the female stops 416 can be part of, attached to, orintegrated with the shuttle 14. As another example, the female stops 416can be part of, attached to, or integrated with the jaws (e.g., jaws330, 38, 78, 80). As yet another example, the device 188 can have somefemale stops 416 that are part of, attached to, or integrated with theshuttle 14 and can have some female stops 416 that are part of, attachedto, or integrated with the jaws (e.g., jaws 330, 38, 78, 80). As yetstill another example, the female stops 416 can be part of, attached to,or integrated with the pushers (e.g., the lower and upper pushers 76,86).

FIGS. 8A-9B illustrate, for example, that the shuttle 14 can have themale stops 412 and that the jaws (e.g., jaws 330, 38, 78, 80) can havethe female stops 416. For example, FIGS. 8A-9B illustrate that theshuttle 14 can have a first male stop 412 a and a second male stop 412b, that the lower jaw (e.g., jaw 38, 80) can have a first female stop416 a (also referred to as the lower jaw first female stop 416 a andother similar terms) configured to releasably engage with or releasablyattach to the first male stop 412 a, and that the upper jaw (e.g., jaw30, jaw 78) can have a second female stop 416 b (also referred to as theupper jaw first female stop 416 b and other similar terms) configured toreleasably engage with or releasably attach to the second male stop 412b. Half of the lower and upper jaws are shown transparent in FIGS. 8A-9Bso that the shuttle 14 can be more easily seen in the jaw tracks (e.g.,lower and upper tracks 66, 64), and so that the male and female stops412, 416 can be more easily seen.

Each male stop 412 can releasably fit into, attach to, or engage with acorresponding female stop 416, for example, via a friction fit, snapfit, magnetic fit, ratchet fit, or any combination thereof. For example,the first male stop 412 a can be configured to releasably attach to thefirst female stop 416 a and the second male stop 412 b can be configuredto releasably attach to the second female stop 416 b. When two stops(e.g., male and female stops 412, 416) are releasably attached to oneanother, a threshold release force can be required to release the stopsfrom one another. The threshold release force can be from about 1.0Newton to about 10.0 Newtons or more, including every 0.5 Newtonincrement within this range (e.g., 4.0 Newtons, 4.5 Newtons, 5.0Newtons). As another example, the release force can be from about 0.5lbs to about 1.5 lbs, including every 0.1 lb increment within this range(e.g., 1.0 lb).

The male stops 412 can be a positive feature such as a protrusion, bump,ridge, arm, extension, flexure, detent flexure, or any combinationthereof. The male stops 412 can be straight and/or curved. The malestops 412 can be flexible, rigid, or both (e.g., a first portion can beflexible and a second portion can be rigid). The male stops 412 can beone or more springs. The female stops 416 can be a negative feature suchas a void, space, pocket, notch, hole, through hole, recess, detentrecess, or any combination thereof. The female stops 416 can beflexible, rigid, or both (e.g., a first portion can be flexible and asecond portion can be rigid). The male and female stops 412, 416 caninclude magnets that attract one another to keep the male and femalestops releasably attached together.

The male stops 412 can have a male surface 414 and the female stops 416can have a female surface 418. The male and female surfaces 414, 418 canbe configured to engage with one another, slidably engage with oneanother, contact one another other, or any combination thereof. Thefemale stops 416 can have a lip 420 configured to engage with, slidablyengage with, or contact the male stop 412, or any combination thereof.The male stops 412 can be configured to engage with, slidably engagewith, or contact the lip 420, or any combination thereof.

For each male-female stop pair, the male and female surfaces 414,418 canengage with one another and/or the male stop 412 can engage with the lip420, for example, when the male stop 412 is being forced into the femalestop 416, when the male stop 412 is being withdrawn from the female stop416, when the female stop 416 is being forced over or onto the male stop412, when the female stop 416 is being withdrawn from the male stop 412,when the male and female stops 412, 416 are attached to one another(also referred to as the stopped position, caught position, fixedposition), or any combination thereof. As another example, two femalestops 416 can engage with one another, for example, where the two femalestops 416 include a magnet. As yet another example, two male stops 412can engage with one another, for example, where the two male stopsinclude a magnet. The male and/or female stops 412, 416 can form a hookor hook-like feature to releasably catch the other stop.

The male stops 412 can move relative to the female stops 416, viceversa, or both. The female stops 416 can move relative to the male stops412, vice versa, or both. For example, FIG. 8A illustrates that the malestops 412 can be translatable (e.g., slidably translatable) in the lowerjaw track, for example, in a first direction toward the first femalestop 416 a and in a second direction away from the first female stop 416a, or vice versa such that the first female stop 416 a is translatabletoward and away from a male stops 412 (e.g., for arrangements where thefemale stop 416 is integrated with or attached to the shuttle 14 and themale stop 412 is integrated with or attached to the lower jaw). Asanother example, FIG. 9A illustrates that the male stops 412 can betranslatable (e.g., slidably translatable) in the upper jaw track, forexample, in a first direction toward the second female stop 416 b and ina second direction away from the second female stop 416 b, or vice versasuch that the second female stop 416 b is translatable toward and awayfrom a male stop 412 (e.g., for arrangements where the female stop 416is integrated with or attached to the shuttle 14 and the male stop 412is integrated with or attached to the upper jaw). The first and seconddirections can be opposite from one another.

FIGS. 8A and 8B illustrate that when the shuttle 14 is being translated(e.g., pushed by the upper jaw pusher 86, pulled by the lower jaw pusher76, or both) in a first direction in the lower jaw track toward thefirst female stop 416 a, the lip 420 can exert a force against the firstmale stop 412 a that causes the first male stop 412 a to flex toward alongitudinal axis of the shuttle 14. This flexure can allow the firstmale stop 412 a to fit into the first female stop 416 a. Upon passing bythe lip 420, the first male stop 412 a can rebound to its neutralposition or to a less flexed position and releasably lock the shuttle 14to the lower jaw via the releasable attachment between the first malestop 412 a and the first female stop 416 a. FIGS. 8A and 8B furtherillustrate that when the shuttle 14 is being translated (e.g., pulled bythe upper jaw pusher 86, pushed by the lower jaw pusher 76, or both) ina second direction (e.g., opposite the first direction) in the lower jawtrack away from the first female stop 416 a, the female surface 418 canexert a force against the first male stop 412 a that causes the firstmale stop 412 a to flex toward a longitudinal axis of the shuttle 14.This flexure can allow the first male stop 412 a to slide under and pastthe lip 420. Upon passing by the lip 420 in the second direction, thefirst male stop 412 a can rebound to its neutral position (also referredto as a non-flexed position). When the first male stop 412 a flexes, itcan deflect into the first suture hole 404 a.

FIGS. 9A and 9B illustrate that when the shuttle 14 is being translated(e.g., pushed by the lower jaw pusher 76, pulled by the upper jaw pusher76, or both) in a first direction in the upper jaw track toward thesecond female stop 416 b, the lip 420 can exert a force against thesecond male stop 412 b that causes the second male stop 412 b to flextoward a longitudinal axis of the shuttle 14. This flexure can allow thesecond male stop 412 b to fit into the second female stop 416 b. Uponpassing by the lip 420, the second male stop 412 b can rebound to itsneutral position or to a less flexed position and releasably lock theshuttle 14 to the upper jaw via the releasable attachment between thesecond male stop 412 b and the second female stop 416 b. FIGS. 9A and 9Bfurther illustrate that when the shuttle 14 is being translated (e.g.,pushed by the upper jaw pusher 86, pulled by the lower jaw pusher 76, orboth) in a second direction (e.g., opposite the first direction) in theupper jaw track away from the second female stop 416 b, the femalesurface 418 can exert a force against the second male stop 412 b thatcauses the second male stop 412 b to flex toward a longitudinal axis ofthe shuttle 14. This flexure can allow the second male stop 412 b toslide under and past the lip 420. Upon passing by the lip 420 in thesecond direction, the second male stop 412 b can rebound to its neutralposition (also referred to as a non-flexed position). When the firstmale stop 412 a flexes, it can deflect into the second suture hole 404b.

The lip 420 can resist passage of the first and second male stops 412 a,412 b along the second direction out of the first and second femalestops 416 a, 416 b with the threshold release force. The female surface418 can be an inner surface of the lip 420. The lip 420 can resistpassage of the first and second male stops 412 a, 412 b along the firstdirection into the first and second female stops 416 a, 416 b with thethreshold release force or a lesser force (e.g., a force 10% to 75% ofthe threshold release force).

The device 188 can have zero, one, or multiple male stops 412 and zero,one, or multiple female stops 416 on the device distal end 2 (e.g.,closer to the jaws than to the handle 104) and/or on the device proximalend (e.g., closer to the handle 104 than to the jaws). For example, theupper jaw (e.g., upper jaw 78) can have one or multiple male stops 412,one or multiple female stops 416, or any combination thereof. The lowerjaw (e.g., lower jaw 80) can have one or multiple male stops 412, one ormultiple female stops 416, or any combination thereof. The male and/orfemale stops 412 and/or 416 can be attached to or integrated with thejaw, the jaw track, or both. The shuttle 14 can have one or multiplemale stops 412, one or multiple female stops 416, or any combinationthereof. The male stops 412 can extend away from and/or toward alongitudinal axis of the shuttle 14. The male stops 412 can extend awayfrom and/or toward a longitudinal axis of a jaw track (e.g., tracks 66and 64). The female stops 416 can extend away from and/or toward alongitudinal axis of the shuttle 14. The female stops 416 can extendaway from and/or toward a longitudinal axis of a jaw track (e.g., tracks66 and 64).

For example, FIG. 8A illustrates that the shuttle 14 can have a firstmale stop 412 a and a second male stop 412 b, and that the lower andupper jaw tracks (e.g., tracks 66 and 64) can each define a female stop416 (e.g., a first female stop 416 a in the lower jaw and a secondfemale stop 416 b in the upper jaw). The lower and upper jaws can eachdefine one or multiple female stops 416. For example, the first malestop 412 a can releasably attach to the first female stop 416 a and thesecond male stop 412 b can releasably attach to a second female stop 416b. FIG. 8A illustrates that the first and second male stops 412 a, 412 bcan extend away from a longitudinal axis (e.g., center longitudinalaxis) of the shuttle toward a longitudinal center of the shuttle 14. Thefirst and second male stops 412 a, 412 b can be the same or a differentdimension away from the longitudinal center of the shuttle 14 as theother detent.

FIGS. 8A-9B further illustrate a surface 422 of jaw suture slots 238,for example, lower jaw suture slot 238 a and upper jaw suture slot 238b.

FIGS. 8B and 9B illustrate that the shuttle tips 164 can have a shuttletip thickness 408 of about 0.05 mm to about 0.75 mm, including every0.05 mm increment within this range (e.g., 0.15 mm, 0.20 mm, 0.25 mm).The shuttle tip thickness 408 can be the width of the non-beveledsurfaces 406. As another example, the shuttle tip thickness 408 can befrom about 0.0080 in. to about 0.0090 in. (e.g., 0.0085 in.).

FIGS. 8B and 9B further illustrate that the shuttle 14 can have ashuttle thickness 410 (also referred to as the shuttle thickness 14_(T)) of about 0.05 mm to about 0.75 mm, including every 0.05 mmincrement within this range (e.g., 0.15 mm, 0.20 mm, 0.25 mm). Theshuttle tip thickness 408 can be the same or different from the shuttlethickness 410. The shuttle tip thickness 408 can be less than, equal to,or greater than the shuttle thickness 410. For example, the shuttle tipthickness 408 can be about 0.15 mm and the shuttle thickness 410 can beabout 0.25 mm, or vice versa.

The shuttle 14 can be made from a single panel of material (e.g.,metal). The suture holes 404 can be cut, leaving the shuttle 14 and themale stops 412. The shuttle 14 can then be bent, which can result in themale stops 412 extending out of the plane of the shuttle spine 160.

FIGS. 8A-9B further illustrate that a portion 423 of the shuttle tips164 can remain exposed outside of the jaws when the shuttle 14 is fullytranslated into the jaws. The exposed portion 423 can have an exposedlength 424, for example, from about 0.25 mm to about 5.00 mm or more,including every 0.25 mm increment within this range (e.g., 0.50 mm, 1.00mm, 1.50 mm). The exposed portion 423 can align the lower and upper jawswhen they close. The exposed portion 423 can pierce tissue when thelower and upper jaws are closed against each other and before theshuttle 14 is translated to the other jaw. This can advantageouslyleverage the clamping force of the jaws to cut tissue with the shuttle14. A portion of the exposed portion 423 can pierce tissue when theshuttle 14 is translated from the lower jaw to the upper jaw, or viceversa.

FIG. 10 illustrates that all or a portion of the exposed portion 423 canbe in the other jaw when the lower and upper jaws are closed and beforethe shuttle 14 is translated to the other jaw via the lower or upperpusher 76, 86. For example, when the jaws are moved from an openconfiguration to a closed configuration with the exposed portion 423extending from the upper jaw (e.g., jaw 30, jaw 78) as shown in FIGS. 8Aand 8B, the exposed portion 423 can be moved into the lower jaw (e.g.,jaw 38, jaw 80) via the jaws closing with or without translation (e.g.,simultaneous translation) of the shuttle 14 into the lower jaw via anupper and/or lower pusher while the jaws are being closed.

FIG. 10 further illustrates that the female stops 416 can have an outersurface 419 and an inner surface 418 (also referred to as a femalesurface). The outer surface 419 can be flat or curved. The outer surface419 can define a ramp surface for the male stops 412 to flex against.The outer surface 419 can define a plane at an angle to a longitudinalaxis of the shuttle. For example, the plane of the outer surface 419 canbe perpendicular or substantially perpendicular to the centerlongitudinal axis of the shuttle. The inner surface can be flat orcurved. The inner surface 418 can define a ramp surface for the malestops 412 to flex against.

FIG. 10 further illustrates that when the lower and upper jaws areclosed the jaws can define a continuous track for the shuttle 14 suchthe lower jaw track 66 and the upper jaw track 64 are continuous withone another. The tracks of the upper jaw and bottom jaw can form acontinuous path when the jaw structure 28 is in a closed configuration.

FIG. 10 further illustrates that the first jaw tip (e.g., jaw tip 46,jaw tip 206) can be configured to interdigitate with the second jaw tip(e.g., jaw tip 48, jaw tip 198). For example, the first jaw tip caninterdigitate with and be adjacent or in contact with the second jaw tipwhen the jaw structure 28 is in a closed configuration. The jaw tips canbe sharpened. The jaw tips can be tapered. The jaw tips can be sharp andseat into each other to form a continuous track when the jaw structure28 is in a closed configuration. The jaw tips can seat into each otherto connect the lower and upper jaw tracks 66, 64 to each other.

FIG. 11A illustrates that the shuttle 14 can have a shuttle first tip164 a and a shuttle second tip 164 b.

FIG. 11A further illustrates that the shuttle 14 can have zero, one, ormultiple shuttle holes 405, for example, 1 to 6 or more shuttle holes405, including every 1 shuttle hole increment within this range (e.g., 2shuttle holes, 4 shuttle holes). The shuttle 14 can have a first shuttlehole 405 a and a second shuttle hole 405 b. The shuttle holes 405 (e.g.,holes 405 a and 405 b) can be the same as or different from the sutureholes 404 (e.g., holes 404 a and 404 b). The male and/or female stops412, 416 can move into and out of the shuttle holes 405, the sutureholes 404, or any combination thereof, for example, via flexing,bending, translating, and/or rotating into and out of the holes 405and/or 404.

FIG. 11A further illustrates that the male stops 412 can have one ormultiple bends 426. For example, FIG. 11A illustrates that the malestops 412 can have a first bend 426 a and a second bend 426 b. The malestops 412 can have inflection points 426 _(IF) where the curvature ofthe male stop 412 changes direction or its concavity. For example, FIG.11A illustrates that the male stops 412 can have an inflection point 426_(IF) between two bends 426 (e.g., between the first and second bends426 a, 426 b) where the male stops 412 change concavity (e.g., fromconcave up for the first bend 426 a to concave down for the second bend426 b as shown in FIG. 11A).

FIG. 11A further illustrates that one or more magnets 428 can beattached to or integrated with the male stops 412 on a first side of thedetents, for example, on or under the first surface 414 (also referredto as a male surface). The magnets 428 can be configured to bemagnetically attracted to a magnet attached to or integrated with theupper or lower jaw having an opposite dipole as the magnets 428.

FIG. 11B illustrates that the one or more magnets 428 can be attached toor integrated with a second surface 415 of the male stops 412, forexample, to an underside of the male stops 412.

FIG. 11B further illustrates that there can be a gap G on each side ofthe male stop 412 between the male stop 412 and the shuttle body 160.The gap G can advantageously inhibit or prevent pressure from forming inthe jaws by allowing gas, liquid, or solids to flow or pass through thegap G as the shuttle 14 is advanced into the jaws. There can be a gap oneach lateral side of the male stop 412 as shown in FIG. 11B. As anotherexample, there may not be any gaps G between the male stops 412 and theshuttle body 160, or the gap G can be on only one side of the male stop412 instead of both sides as shown in FIG. 11B. The gaps G can have agap width Gw that can be, for example, constant (e.g., as shown in FIG.11B) or tapered. As another example, the gaps G can have multiple gapwidths Gw. For example, FIG. 11B further illustrates that the gap G canhave a constant width, for example, as measured between the lateral edgeor surface of the male stop 412 and the lateral edge or surface of theshuttle body 160.

FIG. 11B further illustrates that the terminal tips 165 can have asharpened edge. The sharpened edge can be configured to pierce tissue.

FIG. 11C illustrates that the male stops 412 (e.g., first and secondmale stops 412 a, 412 b) can extend away from a longitudinal axis of theshuttle 14 out of the plane of the shuttle spine 160.

The shuttle longitudinal axis (e.g., longitudinal axis 157) can be flator curved. FIG. 11C illustrates that the shuttle radius of curvature 154can be from about 2.00 mm to about 5.00 mm or more, including every 0.01mm increment within this range (e.g., 2.84 mm).

The shuttle 14 can be straight or have a preformed bend or curve (e.g.,having the radius of curvature 154). The shuttle 14 can have a preformedbend having a radius of curvature of about 40% to about 200% of theradius of curvature 154, including every 1% increment within this range(e.g., 50%).

The curvature of the shuttle 14 can be constant. The curvature of theshuttle 14 can be fixed. The shuttle 14 can be flexible. The shuttle 14can be rigid. The shuttle 14 can transition between curved and straightconfigurations. Having a preformed bend within this range can reduce thestrain on the shuttle 14. For example, the strain can be reduced forvariations where the shuttle 14 shifts between straight and curvedconfigurations when moving within and/or between the jaws.

FIGS. 12A and 12B illustrate a variation of the device 188 in a fullyclosed and fully open configuration, respectively.

FIGS. 12A and 12B illustrate that the jaw control extension 40 can befixed and that the jaws 78 and 80 can move relative to the jaw controlextension 40. For example, the jaws 78 and 80 can move distally andproximally against the jaw control extension 40 to open and close,respectively. The jaws 78 and 80 can move longitudinally along a devicelongitudinal axis 476. The jaws 78 and 80 can move into and out of thecompression cover 34. The jaws 78 and 80 can be attached to a tube 474connected to the handle controls that can translate (e.g., slidablytranslate) the jaws 78 and 80 into and out of the compression cover 34.FIGS. 12A and 12B illustrate that the compression cover 34 can engagewith an upper jaw surface 79 and a lower jaw surface 81 to force thejaws closed when the jaws 78 and 80 are translated proximally toward thehandle and into the compression cover 34. Movement of the jaws 78 and 80in a first direction (e.g., distal movement) against the jaw controlextension 40 can cause the jaws to open and move from the closedconfiguration shown in FIG. 12A to the open configuration shown in FIG.12B. Movement of the jaws 78 and 80 in a second direction (e.g.,proximal movement) against the compression cover 34 can cause the jawsto close and move from the open configuration shown in FIG. 12B to theclosed configuration shown in FIG. 12A. The first and second directionscan be opposite from one another. As another example, the jaws can befixed and the jaw control extension can move relative to the jaws. Thecompression cover 34 can be longitudinally fixed or longitudinallymovable.

The extension head 254 can have the shape shown such that the jaws openrelative to each other when the jaws are moved out of the compressioncover 34 over the extension head 254.

FIG. 12A illustrates the device 188 without a shuttle 14 forillustrative purposes and FIG. 12B illustrates the device 188 of FIG.12A with a shuttle 14.

FIGS. 13A and 13B illustrate a variation of the device 188 in a fullyopened and fully closed configuration, respectively.

FIGS. 13A and 13B illustrate that the handle 104 can have a jaw control8 (also referred to as a trigger), a jaw control release 478 and ashuttle control 479. The jaw control 8 can be pulled with one or morefingers in direction 484 to move the jaw control 8 to the configurationshown in FIG. 13B. The jaw control 8 can translate and/or rotate. Whenthe jaw control 8 is moved in direction 484, the jaws 78 and 80 can movefrom an open configuration to a less open configuration (e.g., to theclosed configuration shown in FIG. 13B). When the jaw control 8 is movedin a direction opposite to direction 484, the jaws 78 and 80 can movefrom a closed configuration to an open configuration (e.g., from theclosed configuration in FIG. 13B to the fully open configurationillustrated in FIG. 13A).

As another example, the handle 104 can have a first press buttonconfigured to close the jaws when pressed and a second press buttonconfigured to open the jaws when pressed.

The jaw control release 478 can be a press button, a switch, a knob, orany combination thereof. The jaw control 8 can lock when the jaws 78 and80 are in the fully closed configuration. Activating the jaw controlrelease 478 can release the jaw control 8 from the lock position. Thejaw control release 478 can be activated, for example, by pressing it.Upon pressing the jaw control release 478, the jaw control 8 can bemanually returned to the position shown in FIG. 13A to fully open thejaws, or the jaw control 8 can automatically return to the positionshown in FIG. 13A.

The shuttle control 479 can be a button, switch, knob, or anycombination thereof. For example, FIGS. 13A and 13B illustrate that theshuttle control 479 can be a switch that can pivot. The shuttle control479 can be locked when the jaws 78 and 80 are in the open configurationof FIG. 13A. When the jaws are closed, the shuttle control can berotated in direction 486 and direction 488. Directions 486 and 488 canbe directed opposite from one another. When the shuttle control 479 ismoved in (e.g., rotated) in direction 486, the upper pusher 86 can movethe shuttle 14 to the lower jaw 80. When the shuttle control 479 ismoved in (e.g., rotated) in direction 488, the lower pusher 76 can movethe shuttle 14 to the upper jaw 78. The shuttle control 479 can have abatwing shape, which can provide ergonomic benefits.

As another example, the handle 104 can have a first press buttonconfigured to move the upper pusher 86 when pressed and a second pressbutton configured to move the lower pusher 76 when pressed.

FIGS. 13A and 13B further illustrate that the device 188 can have aflush port 482 having a luer connection. A cleaning fluid (e.g., enzymecleaner) can be flushed through the device through the flush port 482 toclean it.

FIG. 13C illustrates that the shuttle control 479 can have a neutralposition. When the shuttle control 479 is in the neutral position, oneor neither of the pushers 76 and 86 can be in contact with the shuttle14. When the shuttle control 479 is in the neutral position, the shuttle14 can be ejected from the jaws.

FIG. 13D illustrates the shuttle control 479 in a fully advancedposition when moved in direction 486. When in the shuttle control 479 isin the fully advanced position in direction 486, the upper pusher 86 canbe in a fully advanced position and the lower pusher 76 can be in afully retracted position. For example, the upper pusher 86 can be fullyadvanced toward the lower jaw 80, thereby pushing the shuttle 14 intothe lower jaw 80. The upper pusher 86 can push the shuttle 14 into thelower jaw 80 to the point where detents on the shuttle 14 (male and/orfemale stops 412, 416) releasably engage with detents on the lower jaw80 (male and/or female stops 412, 416).

FIG. 13E illustrates the shuttle control 479 in a fully advancedposition when moved in direction 488. When in the shuttle control 479 isin the fully advanced position in direction 488, the lower pusher 76 canbe in a fully advanced position and the upper pusher 86 can be in afully retracted position. For example, the lower pusher 76 can be fullyadvanced toward the upper jaw 78, thereby pushing the shuttle 14 intothe upper jaw 78. The lower pusher 76 can push the shuttle 14 into theupper jaw 78 to the point where detents on the shuttle 14 (male and/orfemale stops 412, 416) releasably engage with detents on the upper jaw78 (male and/or female stops 412, 416).

The upper and lower jaws referred to throughout the application can beany of the upper and lower jaws disclosed, illustrated, and/orcontemplated herein. For example, the upper and lower jaws 30, 48 can bethe upper and lower jaws 78, 80, respectively. As another example, theupper jaw 30 can be interchangeable with the upper jaw 78, and the lowerjaw 38 can be interchangeable with the upper jaw 80. As yet anotherexample, the upper jaw 30 can also be referred to as the upper jaw 78,and the lower jaw 38 can also be referred to as the lower jaw 80. Thelower jaw can be a first jaw and the upper jaw can be a second jaw. Thelower jaw can be a second jaw and the upper jaw can be a first jaw.

The upper and lower jaw tracks referred to throughout the applicationcan be any of the upper and lower jaw tracks disclosed, illustrated,and/or contemplated herein. For example, the upper and lower jaw tracks64, 66 can be the upper and lower jaw tracks 264, 148, respectively. Asanother example, the upper jaw track 64 can be interchangeable with theupper jaw track 264, and the lower jaw track 66 can be interchangeablewith the upper jaw track 264. As yet another example, the upper jawtrack 64 can also be referred to as the upper jaw track 264, and thelower jaw track 66 can also be referred to as the lower jaw track 148.The lower jaw track can also be referred to as the lower track, and theupper jaw track can also be referred to as the upper track.

FIG. 14A illustrates a variation of a shuttle loader 750 (also referredto as a loader) that can load the shuttle 14 into the device 188, forexample, into the upper jaw 30 or into the lower jaw 38. The loader 750can have a loader body 751 that can have a device space 752. The device188 can be removably positionable in the device space 752. The devicespace 752 can be one or multiple spaces. For example, FIG. 14Aillustrates that the device space 752 can be a recess in the loader body751. The spaces can be recesses, grooves, depressions, or availablespace on the loader 750. FIG. 14A illustrates that the device space 752can include a first jaw space 752 a and a second jaw space 752 b. Forexample, FIG. 14A illustrates that the first jaw space 752 a can be arecess and that the second jaw space 752 b can be a recess. The upperjaw 30 jaw can be placed in the first jaw space 752 a and the lower jaw38 can be placed in the second jaw space 752 b. As another example, thelower jaw 38 jaw can be placed in the first jaw space 752 a and theupper jaw 30 can be placed in the second jaw space 752 b. The device 188can be placed in the device space 752 in a partially open configurationor a fully open configuration. For example, FIG. 14A illustrates thatthe upper and lower jaws 30, 38 can be positionable in the first andsecond jaw spaces 752 a, 752 b when the jaws 30 and 38 are in a fullyopen configuration.

FIG. 14A further illustrates that the loader 750 can have one ormultiple holders 754 that can hold the device 188 and the loader 750together. For example, FIG. 14A illustrates that the holders 754 canhold the device 188 in the device space 752. The holders 754 can be, forexample, clips, clasps, magnets, or fasteners, clasps, catches, pins, orany combination thereof. For example, FIG. 14A illustrates that theholders 754 can be clips that the device 188 can be snapped into whenthe device 188 is placed in the device space 752. As another example,the device space 752 can be sized and shaped to form an interference fit(also referred to as a friction fit) with the device 188 when the device188 is in the device space 752.

FIG. 14A further illustrates that the loader 750 can have a loader bodyshuttle track 756 (also referred to as the shuttle track 756 or thetrack 756). The track 756 can be a track in the loader body 751. Thetrack 756 can be a groove in the loader body 751. The track 756 can be achannel in the loader body 751. The track 756 can have the same radiusof curvature as the shuttle 14. The shuttle 14 can be in the shuttletrack 756 or can be positionable in the shuttle track 756. For example,FIG. 14A illustrates that the loader 750 can be packaged with theshuttle 14 positioned in the shuttle track 756 in the arrangement shown.

The shuttle 14 can be moveable (e.g., translatable, slideable) in thetrack 756. The shuttle 14 can be longitudinally moveable along the track756. For example, the shuttle 14 can be translatable or slideable alongthe track 756. The shuttle 14 can be moveable out of (e.g.,longitudinally out of) the track 756, for example, into the upper jawtrack 64 or into the lower jaw track 66. For example, the shuttle 14 canhave a shuttle first position and a shuttle second position. The shuttle14 can be moveable from the shuttle first position to the shuttle secondposition. The shuttle 14 can be moved from the shuttle first position tothe shuttle second position, for example, in a first direction 763 alongthe track 756. The shuttle 14 can be moved from the shuttle firstposition to the shuttle second position to load the device 188 with theshuttle 14. When the shuttle 14 is in the shuttle first position, theshuttle 14 can be in the track 756. When the shuttle 14 is in theshuttle second position, the shuttle 14 can be in the upper jaw 30 or inthe lower jaw 38, for example, in the upper jaw track 64 or in the lowerjaw track 66. When the shuttle 14 is in the shuttle second position, theshuttle 14 can be in or above the first jaw space 752 a. For example,FIG. 14A illustrates that the shuttle first position can be the shuttle14 in the track 756. The shuttle first position can be the home position(also referred to as the neutral position) of the shuttle 14. The loader750 can be packaged with the shuttle 14 in the shuttle first position.The shuttle second position can be a shuttle loaded position (e.g., afully loaded position, a partially loaded position) of the shuttle 14.

A fully loaded position of the shuttle 14 can be the position of theshuttle 14 when, for example, the shuttle 14 is in the device 188 (e.g.,is in the upper jaw 30 or in the lower jaw 38) and a male stop 412 isengaged with another male stop 412 or with a female stop 416. Where thedevice 188 does not have any stops, the fully loaded position of theshuttle 14 can be, for example, when the shuttle 14 is in the device 188(e.g., is in the upper jaw 30 or in the lower jaw 38) to an extent wherethe upper and lower jaws 30, 38 can be closed (e.g., fully closed) withthe shuttle 14 in the device 188.

A partially loaded position of the shuttle 14 can be any position of theshuttle 14 between the shuttle first position and a fully loadedposition of the shuttle 14. For example, a partially loaded position ofthe shuttle 14 can be, for example, when the shuttle 14 is in the device188 (e.g., is in the upper jaw 30 or in the lower jaw 38) but before amale stop is engaged with another male stop 412 or with a female stop416. Where the device 188 does not have any stops, a partially loadedposition of the shuttle 14 can be, for example, when the shuttle 14 isin the device 188 (e.g., is in the upper jaw 30 or in the lower jaw 38)but the upper and lower jaws 30, 38 cannot be closed with the shuttle 14in the device 188 (e.g., because the shuttle 14 is inhibiting orpreventing the jaws 30 and 38 from being closed), or the jaws 30 and 38can be partially closed but the shuttle 14 prevents the jaws 30 and 38from being fully closed.

FIG. 14A further illustrates that the loader 750 can have the suture 70,the suture loop 162, or both. The suture 70 can be attached to theshuttle 14 or can be attachable to the shuttle 14 with or without thesuture loop 162. For example, FIG. 14A illustrates that the loader 750can be packaged with the suture 70 and the suture loop 162 in thearrangement shown, with the suture loop 162 attached to the shuttle 14.When the device 188 is in the device space 752, the shuttle 14 can beloaded into the device 188.

FIG. 14A further illustrates that the loader 750 can have a cap 758. Thecap 758 can be opaque or transparent. For example, FIG. 14A illustratesthat the cap 758 can be transparent. A transparent cap 758 canadvantageously allow the user to observe the loading process, forexample, so that the user can see whether or not the shuttle 14 isproperly loading into the device 188 during the loading process. Atransparent cap 758 can advantageously allow the user to inspect theshuttle 14 prior to loading the shuttle 14 into the device 188. The cap758 can keep the shuttle 14 in the shuttle track 756. The cap 758 canhave a cap shuttle track 760 (also referred to as the shuttle track 760or the track 760) that can mate with the shuttle track 756. The cap 758can be attached to the loader body 751, for example, with glue. Asanother example, the cap 758 can be removably attached to the loaderbody 751. The cap 758 can define a portion of the device space 752. Thecap 758 can have a finger 758 _(F) (also referred to as an extension).The finger 758 _(F) can constrain or guide movement of the shuttle 14 inthe first jaw space 752 a. The finger 758 _(F) can define a side wall ofthe first jaw space 752 a. The finger 758 _(F) can constrain or guidethe device 188 when in the first jaw space 752 a.

FIG. 14A further illustrates that the loader 750 can have a loadercontrol 762 and a loader control track 764 (also referred to as thetrack 764). The loader control 762 can be, for example, a moveablebutton, a moveable knob, a moveable toggle, a moveable switch, amoveable slide, a translator, a rotator, a slider, or any combinationthereof. The loader control 762 can have an ergonomic shape, forexample, the shape shown in FIG. 14A. For example, FIG. 14A illustratesthat the loader control 762 can have a bean shape (e.g., a kidney beanshape) when viewed from a top view. The loader control 762 can betranslatable and/or rotatable. For example, FIG. 14A illustrates thatthe loader control 762 can be a moveable button. The track 764 can be,for example, a track, a channel, a groove, or a through channel of theloader body 751, or any combination thereof. For example, FIG. 14Aillustrates that the track 764 can extend through the loader body 751.The loader control 762 can be moveable (e.g., translatable, slideable)in and/or along the loader control track 764. The loader control 762 canhave a loader control first position and a loader control secondposition. The loader control 762 can be moveable from the loader controlfirst position to the loader control second position. The loader control762 can be moved from the loader control first position to the loadercontrol second position, for example, in a first direction 765 along thetrack 764. The loader control first position can be at a first end ofthe track 764. The loader control second position can be at the firstend of the track 764, or at a second end of the track 764. For example,FIG. 14A illustrates that the loader control first position can be at afirst terminal end of the track 764. The loader control first positioncan be the home position (also referred to as the neutral position or anon-loaded position) of the loader control 762. The loader 750 can bepackaged with the loader control 762 in the loader control firstposition, with the suture loop 162 attached to the shuttle 14. Theloader control second position can be at a second terminal end of thetrack 764 or any position along the track 764 between the first andsecond terminal ends of the track 764. The loader control secondposition can be a loader control loaded position (e.g., a fully loadedposition, a partially loaded position). For example, the loader controlfirst position can be a non-loaded position of the loader control 762,the loader control positions between the loader control first and secondpositions can be loader control partially loaded positions of the loadercontrol 762, the loader control second position can be a fully loadedposition of the loader control 762, and the loader control positionsbeyond the loader control second position (e.g., along the track 764 indirection 765) can be loader control over-loaded positions of the loadercontrol 762.

A fully loaded position of the loader control 762 can be the position ofthe loader control 762 when, for example, the shuttle 14 is in thedevice 188 (e.g., is in the upper jaw 30 or in the lower jaw 38) and amale stop 412 is engaged with another male stop 412 or with a femalestop 416. Where the device 188 does not have any stops, the fully loadedposition of the loader control 762 can be, for example, when the shuttle14 is in device 188 (e.g., is in the upper jaw 30 or in the lower jaw38) to an extent where the upper and lower jaws 30, 38 can be closed(e.g., fully closed) with the shuttle 14 in the device 188.

A partially loaded position of the loader control 762 can be anyposition of the loader control 762 between the loader control firstposition and a fully loaded position of the loader control 762. Forexample, a partially loaded position of the loader control 762 can be,for example, when the shuttle 14 is in the device 188 (e.g., is in theupper jaw 30 or in the lower jaw 38) but before a male stop is engagedwith another male stop 412 or with a female stop 416. Where the device188 does not have any stops, a partially loaded position of the loadercontrol 762 can be, for example, when the shuttle 14 is in the device188 (e.g., is in the upper jaw 30 or in the lower jaw 38) but the upperand lower jaws 30, 38 cannot be closed with the shuttle 14 in the device188 (e.g., because the shuttle 14 is inhibiting or preventing the jaws30 and 38 from being closed), or the jaws 30 and 38 can be partiallyclosed but the shuttle 14 prevents the jaws 30 and 38 from being fullyclosed.

The loader control 762 can be moveable from the loader control firstposition to the loader control second position to move the shuttle 14into the device 188, for example, to move the shuttle 14 from theshuttle first position to the shuttle second position. To load theshuttle 14 into the device 188, the loader control 762 can be moved(e.g., pushed, pulled, pushed and pulled) from the loader control firstposition to the loader control second position or to a loader controlthird position beyond the loader control second position. The loadercontrol third position can be any position beyond the loader controlsecond position, and can include, for example, the position of theloader control 762 at the second terminal end of the track 764.

When the loader control 762 is in the loader control first position, theshuttle 14 can be in the shuttle first position. When the loader control762 is in the loader control second position, the shuttle 14 can be inthe shuttle second position. When the loader control 762 is in theloader control third position, the shuttle 14 can be in the shuttlesecond position. Moving the loader control 762 from the loader controlfirst position to the loader control second position can move theshuttle 14 from the shuttle first position to the shuttle secondposition or can cause the shuttle 14 to move from the shuttle firstposition to the shuttle second position. For example, when the loadercontrol 762 is moved from the loader control first position to theloader control second position, the loader control 762 can pull thesuture 70 which can in turn pull the shuttle 14. As the loader control762 is moved in the first direction 765, for example, from the loadercontrol first position to the loader control second position, the suture70 between the shuttle 14 and the loader control 762 can be in tension.In this way the loader control 762 can move the shuttle 14 by moving thesuture 70. As another example, the loader control 762 can be directlyattached (e.g., directly removably attached) to the shuttle 14. As yetanother example, the loader control 762 can be the suture 70 itself.

As the loader control 762 is moved from the loader control firstposition to the loader control second position, the shuttle 14 can bemoved along the loader body shuttle track 756, along the cap shuttletrack 760, along the first jaw space 752 a, along a jaw track (e.g., theupper jaw track 64 or the lower jaw track 66), or any combinationthereof. For example, when the loader 750 is used to load the upper jaw30 with the shuttle 14, the shuttle 14 can be moved along the loaderbody shuttle track 756 and the cap shuttle track 760 into the upper jawtrack 64. When the shuttle 14 is in the upper jaw track 64, the shuttlecan be in or above the first jaw space 752 a. When the shuttle 14 is inthe shuttle second position in the upper jaw 30, the loader control 762can be in the loader control second position and the shuttle 14 can befully loaded into the upper jaw track 64 (e.g., the shuttle 14 can be ina fully loaded position in the upper jaw track 64). As another example,when the loader 750 is used to load the lower jaw 38 with the shuttle14, the shuttle 14 can be moved along the loader body shuttle track 756and the cap shuttle track 760 into the lower jaw track 66. When theshuttle 14 is in the lower jaw track 66, the shuttle can be in or abovethe first jaw space 752 a. When the shuttle 14 is in the shuttle secondposition in the lower jaw 38, the loader control 762 can be in theloader control second position and the shuttle 14 can be fully loadedinto the lower jaw track 66 (e.g., the shuttle 14 can be in a fullyloaded position in the upper jaw track 64).

When the loader control 762 is in the loader control second position,the shuttle 14 can be fully loaded into the device 188. Once the loadercontrol 762 is in the loader control second position, the loader control762 can be moveable to the loader control third position, for example,to help make sure the shuttle 14 is fully loaded into the device 188 bythe loader control 762 and/or to let the user know that the shuttle 14is fully loaded into the device 188. As the loader control is moved fromthe loader control second position to the loader control third position,the shuttle 14 may or may not move farther into the device 188 (e.g.,into the upper jaw 30 or into the lower jaw 38), for example, into ashuttle third position. The shuttle third position can be an overloadedposition of the shuttle 14 in the device 188. For example, when theloader control 762 is in the loader control second position and theshuttle 14 is in the shuttle second position fully loaded into thedevice 188, moving the loader control 762 to the loader control thirdposition can cause the loader 750 to provide tactile and/or audiblefeedback to the user (e.g., audible clicks, movement of the suture 70through or around the loader control 762, an audible slipping sound asthe suture 70 is pulled through or around the loader control 762) whichcan indicate that the shuttle 14 is fully loaded into the device 188.

The loader control 762 can be moveable along the track 764 from theloader control first position to the loader control second position indiscrete steps (e.g., stopping at one or more intermediate positionsbetween the loader control first and second positions) and/or in onecontinuous movement, for example, in direction 765 (e.g., the directiontoward the second terminal end of the track 764 along the track 764, forexample, the direction along the track 764 from the first terminal endof the track 764 to the second terminal end of the track 764). Theloader control 762 can be moved along the track 764 from the loadercontrol first position to the loader control second position in discretesteps (e.g., stopping at one or more intermediate positions between theloader control first and second positions) and/or in one continuousmovement, for example, in direction 765 (e.g., the direction toward thesecond terminal end of the track 764 along the track 764, for example,the direction along the track 764 from the first terminal end of thetrack 764 to the second terminal end of the track 764).

The loader control 762 can be moveable along the track 764 from theloader control first position to the loader control third position indiscrete steps (e.g., stopping at one or more intermediate positionsbetween the loader control first and second positions and/or stopping atone or more intermediate positions between the loader control second andthird positions) and/or in one continuous movement, for example, indirection 765 (the direction along the track from the first terminal endof the track 764 to the second terminal end of the track 764). Theloader control 762 can be moved along the track 764 from the loadercontrol first position to the loader control third position in discretesteps (e.g., stopping at one or more intermediate positions between theloader control first and second positions and/or stopping at one or moreintermediate positions between the loader control second and thirdpositions) and/or in one continuous movement, for example, in direction765 (the direction along the track from the first terminal end of thetrack 764 to the second terminal end of the track 764).

The loader control 762 can be moveable along the track 764 in adirection opposite to direction 765 (e.g., the direction toward thefirst terminal end of the track 764 along the track 764, for example,the direction along the track 764 from the second terminal end of thetrack 764 to the first terminal end of the track 764). The loadercontrol 762 can be moved toward the first terminal end of the track 764,for example, to partially or fully unload the shuttle 14 from the device188 back into the track 756. The shuttle 14 can be partially or fullyunloaded from the upper jaw 30 or from the lower jaw 38, for example, ifthere was an error or malfunction during loading such as the shuttle 14being misaligned with the upper or lower jaw 30, 38 or such as thesuture 70 prematurely slipping through the loader control 762. Asanother example, the shuttle 14 can be partially or fully unloaded fromthe device 188 if when the loader control is in the loader controlsecond position or in the loader control third position, the shuttle 14is in a partially loaded position between the shuttle first and secondpositions. Once the shuttle 14 is partially or fully unloaded from thedevice 188 by moving the loader control 762 in toward the first terminalend of the track 764 (e.g., in a direction opposite to direction 765),the shuttle 14 can be loaded or reloaded into the device 188 with orwithout making adjustments to the loader 750 and/or the device 188. Forexample, after the shuttle 14 is unloaded from the device 188, thepositions of the suture 70 and/or the shuttle 14 can be repositioned, asneeded, so that the loader control 762 can load the shuttle 14 into thedevice 188. For example, if a portion of the suture 70 is extendingacross the track 756 after the shuttle is unloaded, the suture 70 can bemoved away from the track 756 so that the suture 70 does not block orinhibit the shuttle 14 from moving along the track 756 and into thedevice 188 as the loader control 762 is moved from the loader controlfirst position to the loader control second position.

FIG. 14A further illustrates that the loader 750 can have a sutureholder 766. The suture holder 766 can be, for example, a suture spool.The suture 70 can have a length of about 3 cm to about 150 cm, includingevery 1 cm increment within this range (e.g., 3 cm, 4 cm, 40 cm, 150cm). The suture holder 766 may or may not hold suture, depending on thelength of the suture. For example, where the suture holder 766 is asuture spool, the suture holder 766 may or may not have suture 70 woundaround it. The loader 750 can be packaged with any length of suture. Forexample, FIG. 14A illustrates that the loader 750 can be packaged with asuture 70 having a length of 4 cm. For a suture length of 4 cm, thesuture holder 766 may or may not hold any of the suture 70. As anotherexample, FIG. 14A illustrates that the loader 750 can be packaged with asuture 70 having a length of 40 cm. For a suture length of 40 cm, thesuture holder 766 can hold some of the suture 70 (e.g., where the sutureholder 766 is a spool, some of the suture 70 can be wound around thesuture holder 766). As the shuttle 14 is loaded into the device 188, forexample, by moving the loader control 762 from the loader control firstposition to the loader control second position, the suture 70 on thesuture holder 766 can be pulled from the suture holder 766. When thesuture 70 is pulled from the suture holder 766, the suture 70 can, forexample, unwind or unfold from the suture holder 766. FIG. 14Aillustrates, for example, that the suture holder 766 can be seen throughholes in the loader body 751.

The suture 70 can be a first suture. A first end of the suture 70 can beconnected to the shuttle 14 (e.g., via the suture loop 162) and a secondend of the suture 70 can be connected to a second suture, for example,to an implantable suture. The second end of the suture 70 can have aloop that can be attachable to the second suture.

FIG. 14A further illustrates that the cap 758 can be on a first side ofthe loader 750 and that the suture holder 766 can be on a second side ofthe loader 750. The first and second sides of the loader 750 can beopposite to each other. For example, FIG. 14A illustrates that the cap758 can be on a front side of the loader 750 and that the suture holder766 can be on the back side of the loader 750.

FIG. 14A further illustrates that the suture 70 can extend from theshuttle 14 under the cap 758 to the loader control 762, can extendthrough the loader control 762 from a first side of the loader 750 to asecond side of the loader 750, and can extend from the loader control762 to the suture holder 766.

FIG. 14A further illustrates that the device 188 can be placed in thedevice space 752 with the upper jaw 30 in the first jaw space 752 a withthe upper and lower jaws 30, 38 in an open configuration (e.g., in apartially open configuration or in a fully open configuration). Forexample, FIG. 14A illustrates that the upper and lower jaws 30, 38 canbe positionable in the first and second jaw spaces 752 a, 752 b,respectively (or vice versa) when the upper and lower jaws 30, 38 are ina fully open configuration. When the upper and lower jaws 30, 38 arepositioned in the first and second jaw spaces 752 a, 752 b, respectively(or vice versa), the upper and lower jaws 30, 38 can be closeableagainst the cap 758. For example, when the upper and lower jaws 30, 38are positioned in the first and second jaw spaces 752 a, 752 b,respectively (or vice versa) in an open configuration, the upper andlower jaws 30, 38 can be partially closed against the cap 758, forexample, by moving the jaw control 8 in direction 484 (e.g., by pullingthe jaw control 8). When the upper and lower jaws 30, 38 are partiallyclosed against the cap 758, the upper and lower jaws 30, 38 can beclamped against the cap 758. Closing the jaws against the cap 758 canadvantageously stabilize the device 188 in the device space 752. Closingthe jaws against the cap 758 can advantageously align the shuttle 14with the jaw track that is in the first jaw space 752 a (e.g., the upperjaw track 64 or the lower jaw track 66). As another example, when theupper and lower jaws 30, 38 are positioned in the first and second jawspaces 752 a, 752 b, respectively (or vice versa), the upper and lowerjaws 30, 38 can be clampable against the cap 758. For example, when theupper and lower jaws 30, 38 are positioned in the first and second jawspaces 752 a, 752 b, respectively (or vice versa) in an openconfiguration, the upper and lower jaws 30, 38 can be clamped againstthe cap 758 by moving the jaws into a partially closed configuration(e.g., by moving the jaw control 8 in direction 484). Clamping the jawsagainst the cap 758 can advantageously stabilize the device 188 in thedevice space 752. Clamping the jaws against the cap 758 canadvantageously align the shuttle 14 with the jaw track that is in thefirst jaw space 752 a (e.g., the upper jaw track 64 or the lower jawtrack 66).

FIG. 14A further illustrates that when the shuttle 14 is in the shuttlefirst position (e.g., in the position shown in FIG. 14A), a portion 768(also referred to as the exposed portion 768) of one of the shuttle tips164 can extend from the cap 758. The portion 768 can be the portion ofthe shuttle 14 that extends out from under the cap 758 when the shuttle14 is in the shuttle first position. The portion 768 can remain exposedoutside of the cap 758 when the shuttle is in the shuttle firstposition. The exposed portion 768 can have an exposed length 768 _(L),for example, from about 0.15 mm to about 5.00 mm or more, includingevery 0.25 mm increment within this range (e.g., 0.15 mm, 1.00 mm, 1.50mm, 5.00 mm). As another example, the exposed length 768 _(L) can be thesame as the exposed length 424.

When the jaws are in a partially closed configuration (e.g., with orwithout being clamped against the cap 758), all or a portion of theexposed portion 768 may not be in the jaw that is in the first jaw space752 a (e.g., the upper jaw 30 or the lower jaw 38). As another example,as the upper and lower jaws 30, 38 are partially closed against the cap758, the jaw in the first jaw space 752 a (e.g., the upper jaw 30 or thelower jaw 38) can close onto all or a portion of the exposed portion768. The exposed portion 768 can align the jaw (e.g., the upper jaw 30or the lower jaw 38) in the first jaw space 752 a during loading, forexample, as the jaw in the first jaw space 752 a closes onto the exposedportion 768. For example, the device 188 can be placed in the devicespace 752 with the upper jaw 30 in the first jaw space 752 a with theupper and lower jaws 30, 38 in an open configuration (e.g., in apartially open configuration or in a fully open configuration). When thejaws are in a partially closed configuration against the cap 758, all ora portion of the exposed portion 768 can be in the jaw that is in thefirst jaw space 752 a (e.g., the upper jaw 30 or the lower jaw 38). Whenthe shuttle 14 is in the shuttle first position and the jaws are closedagainst the cap 758, all or a portion of the exposed portion 768 can bein the jaw that is in the first jaw space 752 a (e.g., the upper jaw 30or the lower jaw 38). The exposed portion 768 can align the jaw that isin the first jaw space 752 a as the upper and lower jaws 30, 38 areclosed together against the cap 758. This can advantageously leveragethe clamping force of the jaws to load the shuttle 14 into the device188 (e.g., into the upper jaw 30 or into the lower jaw 38). When theshuttle 14 is in the shuttle second position, the portion 423 of theshuttle tip 164 can remain exposed outside of the jaw that is in thefirst jaw space 752 a. In this way, a first side of the shuttle 14 canhave the exposed portion 768 when the shuttle 14 is in the shuttle firstposition, and a second side of the shuttle 14 can have the exposedportion 423 when the shuttle 14 is in the shuttle second position. Asanother example, when the shuttle 14 is in the shuttle first positionand the jaws are closed against the cap 758 and/or against the loaderbody 751, all or a portion of the exposed portion 768 can be outside ofthe jaw that is in the first jaw space 752 a (e.g., the upper jaw 30 orthe lower jaw 38). For example, when the shuttle 14 is in the shuttlefirst position and the jaws are closed against the cap 758 and/oragainst the loader body 751, all or a portion of the exposed portion 768can be in the track 756 and/or in the track 760. As another example,when the shuttle 14 is in the shuttle first position and the jaws areclosed against the cap 758 and/or the loader body 751, a first portionof the exposed portion 768 can be in the track 756 and/or in the track760, and a second portion of the exposed portion 768 can be in (e.g.,can extend into) the first jaw space 752 with or without also extendinginto the device 188. As the jaws are closed against the cap 758 and/oragainst the loader body 751, the upper jaw 30 or the lower jaw 38 may ormay not close onto the shuttle 14 (e.g., onto the exposed portion 768).In either case (e.g., the shuttle 14 is in the jaws when the jaws areclamped against cap 758 and/or the loader body 751, or the shuttle 14 isnot in the jaws when the jaws are clamped against the cap 758 and/or theloader body 751), closing the jaws onto the cap 758 and/or onto theloader 751 can advantageously leverage the clamping force of the jaws toload the shuttle 14 into the device 188 (e.g., into the upper jaw 30 orinto the lower jaw 38), for example, by stabilizing the device 188 in oron the loader 750. The shuttle 14 can be loaded into the device from thetrack 756 and/or from the track 760 with or without clamping the jawsonto the cap 758 and/or onto the loader body 751.

The shuttle 14 can be loaded into the device 188 with or without closingthe jaws against the cap 758.

The first jaw space 752 a and/or the second jaw space 752 b can be sizedand shaped to form an interference fit (also referred to as a frictionfit) with the upper jaw 30 and/or the lower jaw 38 when the upper andlower jaws 30, 38 are in the device spaces 752 a, 752 b, respectively(or vice versa). When the first jaw space 752 a is sized and shaped toform an interference fit with the jaw positioned in the first jaw space752 a, the first jaw space 752 a can advantageously stabilize the device188 on the loader 750 by stabilizing the jaw in the first jaw space 752a and can advantageously align the shuttle 14 with the jaw track that isin the first jaw space 752 a (e.g., the upper jaw track 64 or the lowerjaw track 66).

FIG. 14A further illustrates that the loader 750 can have a luer capholder 770 that a luer cap can be removably secured to. The luer capholder 770 can be a recess or a hole in the loader body 751. Forexample, FIG. 14A illustrates that the luer cap holder 770 can be a holein the loader body 751.

FIG. 14A further illustrates that the loader 750 can have a loaderlength 750 _(L). The loader length 750 _(L) can be, for example, about2.50 in. to about 5.00 in., including every 0.01 in. increment withinthis range (e.g., 2.50 in., 3.00 in., 3.50 in., 5.00 in.).

FIG. 14B illustrates that the device 188 can be placed in the devicespace 752. The device 188 can be removably attached to the loader 750 inthe arrangement shown, with the upper jaw 30 in the first jaw space 752a and the lower jaw 38 in the second jaw space 752 b, or vice versa. Forexample, FIG. 14B illustrates that the loader 750 can be used to loadthe upper jaw 30 with the shuttle 14. When the loader control 762 ismoved from the loader control first position to the loader controlsecond position, the shuttle 14 can be moved into the upper jaw 30, forexample, from outside the upper jaw 30 in the shuttle first position toinside the upper jaw 30 in the shuttle second position.

FIG. 14B further illustrates the device 188 attached to the loader 750before the jaws are closed against the cap 758. As another example, FIG.14B illustrates the shuttle 14 can be loaded into the device 188 withoutclosing the jaws against the cap 758. Before the jaws are closed againstthe cap 758, the jaws can float in the first and second jaw spaces 752a, 752 b and may or may not make contact with the cap 758. For example,FIG. 14B illustrates the upper and lower jaws 30, 38 floating in thefirst and second jaw spaces 752 a, 752 b, respectively (or vice versa),with the upper jaw 30 in contact with the cap 758 and with the lower jaw38 not in contact with the cap 758. When the jaws are closed against thecap 758, the upper and lower jaws 30, 38 can be in contact with the cap758. When the jaws are closed against the cap 758, the upper and lowerjaws 30, 38 can be clamped against the cap 758. When the jaws are closedagainst the cap 758, the jaws may not float in the first and second jawspaces 752 a, 752 b.

FIG. 14B further illustrates that when the jaws are in the first andsecond jaw spaces 752 a, 752 b, the exposed portion 768 may not be inthe jaw that is in the first jaw space 752 a.

FIG. 14B further illustrates that the loader 750 can have a luer cap772, and that the luer cap 772 can be removably attached to the luer capholder 770.

FIG. 14B further illustrates that the device 188 can be removablyattached to the loader 750 via the holders 754. For example, FIG. 14Billustrates that the holders 754 can be removably attached thecompression cover 34 of the device 188. As another example, FIG. 14Billustrates that the compression cover 34 of the device 188 can beremovably attached to the holders 754.

FIG. 14B further illustrates that the cap 758 can be opaque.

FIG. 14C illustrates that the cap 758 illustrated in FIG. 14B can betransparent, showing the shuttle 14, the suture loop 162, and the suture70 under the cap 758.

FIG. 14D illustrates that the loader 750 can have loading instructions774. The loading instructions 774 can include, for example, a loadinginstruction first step 774 a, a loading instruction second step 774 b,and a loading instruction third step 774 c. Each loading instructionstep (e.g., loading instruction first, second, and third steps 774 a,774 b, 774 c) can include one or multiple instructions.

FIG. 14D illustrates that when the upper jaw 30 is to be loaded with theshuttle 14, the loading instruction first step 774 a can include, forexample, opening the jaws, moving the upper jaw pusher 86 to a fullyretracted position, and placing the upper jaw 30 is in the first jawspace 752 a and the lower jaw 38 is in the second jaw space 752 b, orany combination thereof. For example, when the upper jaw 30 is to beloaded with the shuttle 14, the loading instruction first step 774 a caninclude an instruction to load the device 188 onto the loader 750 withthe trigger arrangement shown (e.g., with the jaw control 8 and theshuttle control 479 in the positions shown). As another example, theloading instruction first step 774 a can include an instruction to movethe jaw control 8 in direction 485 (e.g., which can be opposite todirection 484) to move the upper and lower jaws 30, 38 into an openconfiguration (e.g., into a fully open configuration), can include aninstruction to move the shuttle control 479 to the fully advancedposition in direction 488 to position the lower jaw pusher 76 in a fullyadvanced position and the upper jaw pusher 86 in a fully retractedposition, or can include both instructions.

As another example, when the lower jaw 38 is to be loaded with theshuttle 14, the loading instruction first step 774 a can include, forexample, opening the jaws, moving the lower jaw pusher 76 to a fullyretracted position, and placing the lower jaw 38 is in the first jawspace 752 a and the upper jaw 30 is in the second jaw space 752 b, orany combination thereof. For example, when the lower jaw 38 is to beloaded with the shuttle 14, the loading instruction first step 774 a caninclude an instruction to load the device 188 onto the loader 750 withthe jaw control 8 in the position shown in FIG. 14D and with the shuttlecontrol 479 in the position shown, for example, in FIG. 13D). Forexample, the loading instruction first step 774 a can include aninstruction to move the jaw control 8 in direction 485 (e.g., which canbe opposite to direction 484) to move the upper and lower jaws 30, 38into an open configuration (e.g., into a fully open configuration), caninclude an instruction to move the shuttle control 479 to the fullyadvanced position in direction 486 (e.g., see FIG. 13D) to position theupper jaw pusher 86 in a fully advanced position and the lower jawpusher 86 in a fully retracted position, or can include bothinstructions.

FIG. 14D illustrates that the loading instruction second step 774 b caninclude moving the loader control 762 from the loader control firstposition to the loader control second position to move the shuttle 14from the shuttle first position to the shuttle second position.

FIG. 14D illustrates that the loading instruction third step 774 c caninclude removing the device 188 from the loader 750.

As another example, the loading instructions 774 can include a loadinginstruction step between the loading instruction first and second steps774 a, 774 b that includes an instruction to close or clamp the jawsagainst the cap 758 by moving the jaw control in direction 484.

FIG. 14D further illustrates that the loader control track 764 can havethe arrangement shown. The loader control 762 is shown transparent forillustrative purposes only, for example, to show the portion of theloader control track 764 under the loader control 762. As anotherexample, the loader control 762 can be transparent. A transparent loadercontrol 762 can advantageously allow the user to observe the suture 70in the loader control 762, for example, so that the user can see whetheror not the loader control 762 is properly pulling the suture 70 duringthe loading process. A transparent loader control 762 can advantageouslyallow the user to inspect the loader control 762 to verify that thesuture 70 is properly positioned in the loader control 762 prior toloading the shuttle 14 into the device 188.

FIG. 14D further illustrates that the loader 750 can be packaged withoutthe suture 70 or the suture loop 162 attached to the shuttle 14. FIG.14D further illustrates that the suture 70 or the suture loop 162 can beattached to the shuttle 14 in the arrangement shown, and that the suture70 can be attached to or passed through the loader control 762 in thearrangement shown.

FIG. 14D further illustrates that the shuttle 14 can be fully under thecap 758, for example, such that the shuttle 14 does not have the portion768 extending out from under the cap 758 when the shuttle is in theshuttle first position (e.g., the position of the shuttle 14 in FIG.14D).

FIG. 14D further illustrates that the luer cap 772 can be covered by theloading instructions 774. The loading instructions 774 can indicate thelocation of the luer cap 772. For example, FIG. 14D illustrates that theluer cap 772 is under “LUER CAP” on the loading instructions 774. Toremove the luer cap 772 from the loader 750, the loading instructions774 (e.g., the portion of the loading instructions 774 having theloading instruction second and third steps 774 b, 774 c) can be removedfrom the loader 750 (e.g., like a pull tab). As another example, toremove the luer cap 772 from the loader 750, the luer cap 772 can bepushed through the portion of the loading instructions 774 that coverthe luer cap 772. Pushing the luer cap 772 through the loadinginstructions 774 can tear the loading instructions 774. As yet anotherexample, to remove the luer cap 772 from the loader 750, the luer cap772 can be removed from the back side of the loader 750 without havingto remove or tear through the loading instructions 774.

FIG. 14D further illustrates that the loader control 762 can have aloader control first side 762 _(FS) and a loader control second side 762_(SS). The loader control first side 762 _(FS) can be on a first side ofthe loader 750 and the loader control second side 762 _(SS) can be on asecond side of the loader 750. For example, FIG. 14D illustrates thatthe loader control first side 762 _(FS) can be on a front side of theloader 750 and that the loader control second side 762 _(SS) can be onthe back side of the loader 750. As shown in FIG. 14D, the loadercontrol 762 can extend through the track 764.

The loader control first side 762 _(FS) can be moveable toward theloader control second side 762 _(SS). A portion of the loader controlfirst side 762 _(FS) can be moveable toward the loader control secondside 762 _(SS). A portion of the loader control second side 762 _(SS)can be moveable toward the loader control first side 762 _(F)s. Forexample, the loader control first side 762 _(FS) and/or the loadercontrol second side 762 _(SS) can have a loader control suture holder(e.g., see FIG. 19A for exemplary illustrated details) that can hold orlock the suture 70 in the loader control 762 as the loader control 762is moved from the loader control first position to the loader controlsecond position. The loader control suture holder can advantageouslyinhibit or prevent the suture 70 from slipping through the loadercontrol 762 as the loader control 762 is moved from the loader controlfirst position to the loader control second position. For example, theloader control suture holder can prevent the suture 70 from slidingthrough the loader control suture holder in the loader control 762 untila loader control threshold force is reached or exceeded. When the loadercontrol threshold force is reached or exceeded, the suture 70 can slipor slide through the loader control suture holder in the loader control762. In this way the loader control suture holder can advantageouslyinhibit or prevent the suture 70 from breaking or fraying, allowing thesuture to slip or slide through the loader control 762 when the loadercontrol 762 pulls the suture 70 and the shuttle 14 with a force equal toor greater than the loader control threshold force. The loader controlthreshold force can advantageously inhibit or prevent the integrity ofthe suture 70 from breaking or becoming damaged during the loadingprocess.

The loader control suture holder can be, for example, a pad that thesuture 70 can pass through. The pad can have a living hinge. The pad canbe, for example, a silicon pad with two sides connected by the livinghinge. As another example, the loader control suture holder can have twopads connected by a living hinge. The two pads and the living hinge canbe, for example, a single silicon pad with a living hinge folded over onitself. The suture 70 can pass between the two pads of the loadercontrol suture holder, or can pass between the two sides of a single padof the loader control suture holder. When the loader control first side762 _(FS) and the loader control second side 762 _(SS) are pressedtogether, the pad of the loader control suture holder can clamp thesuture 70 in the loader control 762, preventing the suture 70 fromslipping through the loader control 762 until the loader controlthreshold force is reached or exceeded as the loader control 762 ismoved from the loader control first position to the loader controlsecond position.

FIG. 14D further illustrates that the loader control 762 can have one ormultiple loader control suture tracks 775 (also referred to as thetracks 775) that the suture 70 can be positionable in and/or that thesuture 70 can be moveable in. The suture 70 can move (e.g., slide,translate) in the tracks 775, for example, as the suture 70 is pulledthrough the loader control 762. The tracks 775 can be one or multiplegrooves or channels in the loader control 762. For example, FIG. 14Dillustrates that the loader control first side 762 _(FS) can have atrack 775 and that the loader control second side 762 _(SS) can have atrack 775. The tracks 775 can advantageously keep the suture 70 at orbelow a surface of the loader control 762 so that the suture is notdamaged by the user (e.g., via pulling, twisting, or rolling the suture70) as user moves the loader control 762 from the loader control firstposition to the loader control second position.

FIG. 14E illustrates that the loader 750 can be packaged with the suture70 attached to the shuttle 14, for example, via the suture loop 162.Half of the upper and lower jaws 30, 38 in FIG. 14E are showntransparent for illustrative purposes only, for example, so that therelationship between the upper and lower jaw tracks 64, 66 and theshuttle 14 when the shuttle 14 is in the shuttle first position can bemore easily seen. The upper jaw 30 is shown without the cover 556 andthe lower jaw 38 is shown with the cover 556, for example, to illustratethat the device 188 can be attached to the loader 750 in the devicespace 750 with or without the cover 556. The cover 556 over the lowerjaw 38 in FIG. 14E is shown opaque, but it can be transparent.

FIG. 14E further illustrates, for example, that when the jaws are in thefirst and second jaw spaces 752 a, 752 b, the exposed portion 768 can bealigned with the shuttle track of the jaw that is in the first jaw space752 a. For example, FIG. 14E illustrates that when the upper jaw 30 isin the first jaw space 752 a, the shuttle tip 164 can be aligned withthe upper jaw track 64 such that the shuttle 14 can be loaded into theupper jaw 30 when the loader control 762 is moved from the loadercontrol first position to the loader control second position.

FIG. 14E further illustrates, for example, that the loader 750 can havea loader body suture track 776 (also referred to as the suture track 776or the track 776). The track 776 can be a track in the loader body 751.The track 776 can be a groove in the loader body 751. The track 776 canbe a channel in the loader body 751. The track 776 can be a ledge. Forexample, FIG. 14E illustrates that the track 776 can be a ledge. Thetrack 776 can be parallel to the track 756. The track 776 can have aradius of curvature greater than, less than, or equal to the radius ofcurvature of the shuttle 14. The track 776 can have a radius ofcurvature greater than, less than, or equal to the radius of curvatureof the track 756. The suture 70 and/or the suture loop 162 can be in thetrack 776 or can be positionable in the track 776. For example, FIG. 14Eillustrates that the suture loop 162 can be in the track or can bepositionable in the track 776. For example, FIG. 14E illustrates thatthe loader 750 can be packaged with the suture loop 162 attached to theshuttle 14 and positioned in the track 776 in the arrangement shown, forexample, when the shuttle 14 is in the shuttle first position and theloader control 762 is in the loader control first position.

The suture 70 and/or the suture loop 162 can be moveable (e.g.,translatable, slideable) in the track 776. The suture 70 and/or thesuture loop 162 can be longitudinally moveable along the track 776. Forexample, the suture 70 and/or the suture loop 162 can be translatable orslideable along the track 776. The suture 70 and/or the suture loop 162can be moveable out of (e.g., longitudinally out of) the track 776, forexample, into the upper jaw track 64 and/or into the upper jaw sutureslot 238 b. The suture 70 and/or the suture loop 162 can be moveable outof (e.g., longitudinally out of) the track 776, for example, into thelower jaw track 66 and/or into the lower jaw suture slot 238 a. Forexample, when the shuttle 14 is in the shuttle first position, FIG. 14Eillustrates that the shuttle 14 can be in the track 756 and that thesuture loop 162 can be in the track 776. When the shuttle 14 is in theshuttle second position and has been loaded into the upper jaw 30, theshuttle 14 can be in the upper jaw 30, and the suture loop 162 can be inthe upper jaw track 64 and/or in the upper jaw suture slot 238 b. Whenthe shuttle 14 is in the shuttle second position and has been loadedinto the lower jaw 38, the shuttle 14 can be in the lower jaw 38, andthe suture loop 162 can be in the lower jaw track 66 and/or in the lowerjaw suture slot 238 a.

FIG. 14E further illustrates that the shuttle body can have a loaderbody surface 778 (also referred to as the surface 778). The surface 778can form an edge of the track 776. The surface 778 can form an edge ofthe first jaw space 752 a. The surface 778 can form an edge of thesecond jaw space 752 b. For example, FIG. 14E illustrates that thesurface 778 can abut or form the edge of the first and second jaw spaces752 a, 752 b. FIG. 14E illustrates that the male stops 412 on theshuttle 14, the suture loop 162, and the suture 70 can extend over thesurface 778. The male stops 412 on the shuttle 14, the suture loop 162,and the suture 70 can be moveable across the surface 778, for example,as the shuttle 14 is moved from the shuttle first position to theshuttle second position. The male stops 412 on the shuttle 14, thesuture loop 162, and/or the suture 70 may or may not contact the surface778. For example, as the shuttle 14 is moved from the shuttle firstposition to the shuttle second position, the male stops 412 on theshuttle 14, the suture loop 162, and/or the suture 70 may or may notcontact the surface 778. For example, FIG. 14E illustrates that as theshuttle 14 is moved from the shuttle first position to the shuttlesecond position, the male stops 412 on the shuttle 14, the suture loop162, and/or the suture 70 can extend over the surface 778 withoutcontacting the surface 778 as the male stops 412 on the shuttle 14, thesuture loop 162, and/or the suture 70 are moved across the surface 778by the loader control 762 as the loader control 762 is moved, forexample, from the loader control first position to the loader controlsecond position.

FIG. 14F illustrates the device 188 in the loader 750 with the cap 758shown transparent for illustrative purposes only. As another example,FIG. 14F illustrates that the loader 750 may not have a cap (e.g., thecap 758).

FIG. 14F further illustrates that the first jaw space 752 a can bedeeper than the track 756, and that the track 756 can be deeper than thetrack 776. For example, the first jaw space 752 a can have a first jawspace depth, the track 756 can have a loader body shuttle track depth,and the track 776 can have a loader body suture track depth. FIG. 14Fillustrates, for example, that the first jaw space depth can be greaterthan the loader body shuttle track depth, and the loader body shuttletrack depth can be greater than the loader body suture track depth. FIG.14F further illustrates that the surface 778 and the bottom surface ofthe track 776 can be the same level as each other. As another example,the track 776 can be deeper than the surface 778. As yet anotherexample, the surface 778 can form the track 776.

FIG. 14F further illustrates that the suture 70 can extend from theshuttle 14 toward the loader control 762 and loop around the loader 750from a first side of the loader 750 to a second side of the loader 750through the loader control 762. For example, FIG. 14F illustrates thatthe suture 70 can extend through the loader control 762 (e.g., throughthe loader control suture holder).

FIG. 14F further illustrates that the lower jaw 38 can be placed in thefirst jaw space 752 a and that the upper jaw 30 can be placed in thesecond jaw space 752 b.

FIG. 15A illustrates that the jaws can be clamped against the loaderbody 751 (e.g., by pulling the jaw control 8). When the jaws are clampedagainst the loader body 571, the shuttle 14 can be loaded into thedevice 188 via the loader control 762. As another example, half of thejaws can be clamped against the loader body 751 and half of the jaws canbe clamped against the cap 758 (e.g., shown transparent in FIG. 15A).FIG. 15A shows the loader 750 and the device 188 of FIG. 14E in amid-loaded configuration (also referred to as a partially loadedconfiguration). As for FIG. 14E, half of the upper and lower jaws 30, 38in FIG. 15A are shown transparent for illustrative purposes only, forexample, so that the relationship between the upper and lower jaw tracks64, 66 and the shuttle 14 when the shuttle 14 is between the shuttlefirst and second positions can be more easily seen. The upper jaw 30 isshown without the cover 556 and the lower jaw 38 is shown with the cover556, for example, to illustrate that the device 188 can be attached tothe loader 750 in the device space 752 with or without the cover 556.

FIG. 15A illustrates the loader control 762 can be moved away from theloader control first position to a loader control intermediate positionbetween the loader control first and second positions. FIG. 15Aillustrates that when the loader control 762 is in an intermediateposition, the shuttle 14 can be between the shuttle first and secondpositions, for example, in a shuttle intermediate position. Theintermediate position of the loader control 762 illustrated in FIG. 15Ais also referred to as the loader control first intermediate position.The intermediate position of the shuttle 14 illustrated in FIG. 15A isalso referred to as the shuttle first intermediate position.

FIG. 15A illustrates, for example, the loader 750 in a partially loadedconfiguration and the device 188 in a partially loaded configuration.When the loader 750 is in a partially loaded configuration, the loadercontrol 762 can be between the first and second terminal ends of thetrack 764. When the loader 750 is in a partially loaded configuration,the loader control 762 can be between the loader control first positionand the loader control second position, for example, in an intermediateposition between the loader control first and second positions as shownin FIG. 15A. When the loader 750 is in a partially loaded configuration,the suture loop 162 can extend over the track 756, the track 776, andthe surface 778. When the device 188 is in a partially loadedconfiguration, a first end of the shuttle 14 can be in the device 188(e.g., in the upper jaw 30 or in the lower jaw 38) and a second end ofthe shuttle 14 can be outside of the device 188, for example, in thetrack 756. When the loader 750 is in a partially loaded configuration,the shuttle 14 can be between the shuttle first position and the shuttlesecond position, for example, in an intermediate position between theshuttle first and second positions as shown in FIG. 15A. When the device188 is in a partially loaded configuration, the suture loop 162 canextend over the track 756, the track 776, and the surface 778.

FIG. 15B illustrates that the loader control 762 can be moved away fromthe loader control first intermediate position to a loader controlsecond intermediate position, where the loader control secondintermediate position can be between the loader control first and secondpositions. The loader control second intermediate position can bebetween the loader control first intermediate position and the loadercontrol second position. FIG. 15B illustrates that when the loadercontrol 762 is in the loader control second intermediate position, theshuttle 14 can be between the shuttle first and second positions, forexample, in a shuttle second intermediate position. The shuttle secondintermediate position can be between the shuttle first intermediateposition and the shuttle second position.

FIG. 15B illustrates, for example, the loader 750 in a partially loadedconfiguration and the device 188 in a partially loaded configuration.When the loader and the device 750, 188 are in a partially loadedconfiguration and the loader control 762 is in the loader control secondintermediate position, the suture loop 162 can be in the upper jaw 30,extend through the upper jaw suture slot 238 b, and extend over both thefirst jaw space 752 a and the surface 778. FIG. 15B illustrates thesuture 70 and the suture loop 162 can be fully out of the track 776.When the device 188 is in a partially loaded configuration and theloader control 762 is in the loader control second intermediateposition, a first end of the shuttle 14 can be in the device 188 (e.g.,in the upper jaw 30 or in the lower jaw 38) and a second end of theshuttle 14 can be outside of the device 188, for example, in the track756. FIG. 15B illustrates that both of the male stops 412 illustrated inFIG. 15A can be in the upper jaw 30 (e.g., they no longer extend overthe surface 778). In the partially loaded configuration shown in FIG.15B, the male stops 412 may not be engaged with a female stop 416.

FIG. 15B further illustrates that the loader control 762 (e.g., theloader control first side 762 _(FS)) can have a loader control channel780 (also referred to as the channel 780). The channel 780 can be theopening to the loader control suture holder. FIG. 15B illustrates thatthe suture 70 can extend into the channel 780, for example, from theshuttle 14.

FIG. 15C illustrates that the surface 778 and the track 776 can be thesame height. As another example, the surface 778 can define the track776.

FIG. 15C further illustrates that the cap 758 can be placed on a surface782. The surface 782 can be above the track 776 and the surface 778, forexample, to provide clearance (e.g., a gap, a space) between the cap 758and the surface 778 for the suture 70, the suture loop 162, and/or themale stops 412 to extend into when the cap 758 is attached to the loader750. The cap 758 can be attached to (e.g., glued to) or rest against thesurface 782. The cap 758 can be attached to the cap attachers 784. Thecap attachers 784 can be, for example, posts or masts. For example, thecap 758 can be glued to the posts 784. As another example, the cap 758can be removably attachable to the posts 784, for example, with afriction fit, a snap fit, or a magnetic fit. When the cap 758 isattached to the cap attachers 784, the cap 758 can contact or restagainst the surface 782.

FIG. 15D illustrates that when the loader control 762 is in a loadercontrol intermediate position, for example, the intermediate positionshown in FIG. 15C, the loader 750 and the device 188 can have thearrangement of features shown, for example, with the suture 70 extendingacross the surface 778 to the loader control 762.

FIG. 15E illustrates that when the cap 758 is attached to the loader750, a bottom surface of the cap 758 can be in contact with the surface782.

FIG. 15E further illustrates that when the cap 758 is attached to theloader 750, a space 786 (also referred to as a gap 786) can be betweenthe cap 758 and the surface 778 for the suture 70, the suture loop 162,and/or the male stops 412 to extend into and/or move through. The suture70, the suture loop 162, and/or the male stops 412 can be moveable inthe space 786.

FIG. 15E further illustrates that the track 756 can be opposite of thetrack 760 such that a first lateral side of the shuttle 14 is moveablein the track 756 and a second lateral side of the shuttle 14 is moveablein the track 760.

FIG. 15F illustrates that the suture loop 162 can be in the gap 786. Thesuture loop 162 can be in the gap 786, for example, when the loadercontrol 762 is in the loader control first position, is in the loadercontrol second position, and/or is in any position between the loadercontrol first and second positions. As another example, the suture loop162 may no longer extend through the gap 786 when the loader control 762is in the loader control second position. For example, FIG. 15F canillustrate a cross-sectional view of FIG. 14A with the cap 758 attachedto the loader 750. As another example, FIG. 15F can illustrate across-sectional view of FIG. 15A with the cap 758 attached to the loader750. As yet another example, FIG. 15F can illustrate a cross-sectionalview of FIG. 15B with the cap 758 attached to the loader 750.

FIG. 15F further illustrates that the gap 786 can be between the cap 758and the loader body 751, for example, to inhibit or prevent the suture70 from lifting out of the plane that extends, for example, between theshuttle 14 and the loader control 762, and that FIG. 15F shows can beparallel to the surface 778.

FIG. 15F further illustrates that the surface defining the track 776 andthe surface 778 can be same level as each other. For example, thesurface defining the track 776 and the surface 778 can be the samedistance away from the bottom of the cap 758.

FIG. 16 illustrates that the loader control 762 can be moved to theloader control second position. For example, FIG. 16 illustrates thatthe loader control 762 can be moved away from the loader control secondintermediate position to the loader control second position. FIG. 16illustrates that when the loader control 762 is in the loader controlsecond position, the loader 750 and the device 188 can have thearrangement of features as shown. FIG. 16 illustrates, for example, thatwhen the loader control 762 is in the loader control second position,the shuttle 14 can be in the shuttle second position, and that theshuttle second position can be a fully loaded position. When the loadercontrol 762 is in the loader control second position, FIG. 16illustrates that a male stop can be engaged with a female stop. When theloader control 762 is moved into the loader control second position(e.g., from the loader control first position), the shuttle 14 can bemoved out of the track 756 into the device 188 (e.g., into the upper jaw30 or into the lower jaw 38), the suture loop 162 can be moved out of oroff of the track 776 onto or over the surface 778 and/or onto or overthe first jaw space 752 a, and the suture 70 can moved out of or off ofthe track 776 and onto or over the surface 778 and/or onto or over thefirst jaw space 752 a, or any combination thereof. FIG. 16 furtherillustrates that when the loader control 762 is in the loader controlsecond position, the exposed portion 423 can extend from the device 188.As another example, when the loader control 762 is in the loader controlsecond position and the shuttle 14 is in the shuttle second position,the shuttle 14 can be fully in the device 188, for example, such thatthe shuttle 14 does not extend from the device 188 or does not have anexposed portion (e.g., exposed portion 423).

FIG. 16 further illustrates that the suture 70 and/or the suture loop162 can extend under the cap 758 (e.g., under a finger of the cap 758),for example, through the space 786, when the loader control 762 is inthe loader control second intermediate position shown in FIG. 15B.

FIG. 16 further illustrates that the cap 558 can be placed over thetrack 756.

FIG. 16 further illustrates that half of the jaws can be clamped againstthe loader body 751 and that half of the jaws can be clamped against thecap 751.

FIG. 17A illustrates that the loader control 762 can be moved to theloader control third position. FIG. 17A illustrates that when the loadercontrol 762 is in the loader control third position, the loader 750 andthe device 188 can have the arrangement of features as shown.

FIG. 17A illustrates, for example, that when the loader control 762 isin the loader control third position, the shuttle 14 can be in theshuttle second position, and that the shuttle second position can be afully loaded position. As another example, when the loader control 762is in the loader control third position, the shuttle 14 can be in ashuttle third position, which can be an overloaded position in thedevice 188. When the shuttle 14 is in the shuttle third position, moreof the shuttle 14 can be in the device 188 than when the shuttle 14 isin the shuttle second position. For example, when the shuttle 14 is inthe shuttle second position, the exposed portion 423 can extend from thedevice 188, and when the shuttle 14 is in the shuttle third position,less of the exposed portion 423 can extend from the device 188 or theshuttle 14 can be completely in the device 188. As another example, theshuttle 14 can have the same position (e.g., the shuttle secondposition) when the loader control 762 is in the loader control secondposition and when the loader control 762 is in the loader control thirdposition.

FIG. 17A further illustrates that when the loader control 762 is in theloader control third position, the loader control 762 can be at thesecond terminal end of the track 764. When the loader control 762 is inthe loader control third position, the suture 70 and the suture loop 162can be in the positions shown. When the loader control 762 is in theloader control third position, FIG. 17A illustrates that a male stop canbe engaged with a female stop. As the loader control 762 is moved fromthe loader control second position to the loader control third position,the suture 70 can slip through the loader control suture holder. Theloader control suture holder can be a friction member that the suture 70can slip through. As for FIGS. 14E and 15A, the cap 758 and half of theupper and lower jaws 30, 38 in FIG. 17A are shown transparent forillustrative purposes only, for example, so that the relationshipbetween the upper and lower jaw tracks 64, 66 and the shuttle 14 whenthe shuttle 14 is in the shuttle third position can be more easily seen.The upper jaw 30 is shown without the cover 166 and the lower jaw 38 isshown with the cover 556, for example, to illustrate that the device 188can be attached to the loader 750 in the device space 752 with orwithout the cover 556.

FIG. 17B illustrates that when the loader control 762 is moved into theloader control third position (e.g., from the loader control firstposition), the shuttle 14 can be moved out of the track 756 into thedevice 188 (e.g., into the upper jaw 30 or into the lower jaw 38), thesuture loop 162 can be moved out of or off of the track 776 onto or overthe surface 778 and/or onto or over the first jaw space 752 a, and thesuture 70 can moved out of or off of the track 776 and onto or over thesurface 778 and/or onto or over the first jaw space 752 a, or anycombination thereof.

FIG. 17B further illustrates that when the loader control 762 is in theloader control third position, the exposed portion 423 can extend fromthe device 188. As another example, when the loader control 762 is inthe loader control second position and the shuttle 14 is in the shuttlesecond position, the shuttle 14 can be fully in the device 188, forexample, such that the shuttle 14 does not extend from the device 188,does not have an exposed portion (e.g., exposed portion 423), or less ofthe exposed portion 423 is exposed when the loader control 762 is in theloader control third position than when in the loader control secondposition.

FIG. 17C illustrates the arrangement of features shown, for example,that the surface 782 can be a ledge, that the track 776 can be a ledge,that the track 756 can be a channel, that the surface 778 can form aledge that abuts and forms a wall of the track 756, and that the surface778 and the surface forming the track 776 can be the same height (e.g.,the same height above the bottom of the track 756.

FIG. 18 illustrates that the suture holder 766 can be attached to (e.g.,removably attached to) the loader 750. The suture holder 766 can beattached to the front side or the back side of the loader 750. Forexample, FIG. 18 illustrates that the suture holder 766 can be attachedto the back side of the loader 750.

FIG. 18 further illustrates that loader 750 can have one or multipleholders 788 that can hold the suture holder 766 and the loader 750together. For example, FIG. 18 illustrates that the holders 788 can holdthe suture holder 766 on the back side of the loader 750. The holders788 can be, for example, clips, clasps, magnets, or fasteners, clasps,catches, pins, or any combination thereof. For example, FIG. 18illustrates that the holders 788 can be clips that the suture holder 766can be snapped into. FIG. 18 illustrates that the loader 750 can bepackaged with the suture holder 766 attached to the loader 750, forexample, in the arrangement shown with suture 70 on (e.g., wound around)the suture holder 766. The holders 788 can be part of the loader body751. The holders 788 can be extensions of the loader body 751. Theholders 788 can extend from the loader body 751.

FIG. 18 further illustrates that the suture holder 766 can be rotatablefor example, in direction 766 a, in direction 766 b, or in directions766 a and 766 b. When the suture holder 766 is attached to the loader750 (e.g., in the position shown in FIG. 18), the suture holder 766 canbe rotatable (e.g., in directions 766 a and/or 766 b). For example, thesuture holder 766 can rotate in direction 766 a as the loader control762 is moved (e.g., from the loader control first position to anysubsequent position, for example, to the loader control second positionand/or to the loader control third position). The suture 70 can releasefrom the suture holder 766 as the suture holder rotates in direction 766a. As another example, the suture holder 766 can rotate in direction 766a as the loader control 762 but the suture 70 may not begin releasing(e.g., passively releasing) from the suture holder 766 until the loadercontrol 762 is in the loader control second position or beyond. Forexample, FIG. 18 further illustrates that the suture holder 766 can havea suture grabber 790 that can inhibit or prevent the suture 70 fromreleasing (e.g., unspooling, unwinding) from the suture holder 766 untilthe loader control 762 is in the loader control second position orbeyond. This can advantageously keep the suture 70 in tension while theshuttle 14 is being loaded into the device 188 via the loader control762. For example, the suture grabber 790 can have a track 791 that thesuture 70 can extend through. The track 791 can be a channel, a groove,or a hole in the suture holder 766. For example, FIG. 18 illustratesthat the track 791 can be a groove or a channel. The track 791 can havecurve (e.g., the crescent curve shown) so that the suture 70 isinhibited from releasing from the suture grabber 790 until the loadercontrol 762 is in the loader control second position or until the loadercontrol threshold force is reached or exceeded. Once the loader control762 is in the loader control second position, movement of the loadercontrol 762 further in direction 765, for example, to the loader controlthird position, can release the suture 70 from the suture grabber 790 byturning the suture holder 766 to such an extent that that the suture 70can be pulled out of the track 791 as the loader control 762 is movedbeyond the loader control second position. Once the suture 70 is pulledout of the track 791, the suture 70 can release (e.g., unwind, unspool)from the suture holder 766.

When the loader control 762 is in any position, the user can pull thesuture 70 (e.g., with their hands) to release (e.g., actively release)the suture 70 from the suture holder 766. Passive release from thesuture holder 766 can be when movement of the loader control 762releases the suture 70 from the suture holder 766 and passive releasefrom the suture holder 766 can be when the user removes the suture 70from the suture holder 766, for example, by pulling the suture 70. Forexample, when the shuttle 14 is fully loaded into the device 188 (e.g.,when the shuttle 14 is in the shuttle second position and the loadercontrol 762 is in any position ranging from the loader control secondposition to the loader control third position), the user can release thedevice 188 from the loader 750 and can pull the rest of the suture 70off of the suture holder 766 (e.g., through the loader control 762), forexample, directly with their hands or simply by pulling the device 188and the loader 750 away from each other.

FIG. 18 further illustrates that the suture holder 766 can have ribs 792that can engage with rib engagers 794. The loader 750 can have, forexample, 1 to 3 or more rib engagers 794. For example, FIG. 18illustrates that the loader 750 can have three rib engagers 794, spaced120 degrees apart from each other. The ribs and rib engagers 792, 794can inhibit or prevent the suture holder 766 from moving in direction766 a and/or in direction 766 b before use (e.g., when packaged). Theribs and rib engagers 792, 794 can provide tactile and/or audiblefeedback to the user that can indicate that the suture holder 766 isrotating in direction 766 a during loading. The audible feedback can be,for example, audible clicks that are generated as the suture holderrotates and the ribs 792 rotate past the rib engagers 794.

FIG. 18 further illustrates that the suture holder 766 can be a spool.

FIG. 18 further illustrates that the track 775 on the loader controlsecond side 762 _(SS) can have the arrangement shown, for example, thatit can extend across the outer surface of the loader control second side762 _(SS).

As the loader control 762 is moved from the loader control firstposition to the loader control second position or to the loader controlthird position, the suture 70 can, for example, passively release (e.g.,unspool) from the suture holder 766.

The loader 750 can be packaged with or without suture 70 on (e.g., woundaround) the suture holder 766. For example, FIG. 18 illustrates that theloader 750 can be packaged with the suture 70 wound around the sutureholder 766. Where the loader 750 is not packaged with the suture 70attached to the loader 750, the suture 70 can be attached to the sutureholder and extended through the loader 762 before use.

FIG. 19A illustrates that the loader control suture holder can be theloader control suture holder 795. FIG. 19A illustrates that the loadercontrol 762 can have or can be the loader control suture holder 795. Theloader control suture holder 795 can be a friction member that inhibitsor prevents the suture 70 from slipping through the loader control 762until the loader control threshold force is reached or exceeded. Forexample, the loader control suture holder 795 can, for example, have apad 796 that the suture 70 can pass through. The pad can be, forexample, a silicon pad. The loader control suture holder 795 can have aliving hinge 797. The living hinge 797 can be, for example, a portion(e.g., a middle portion, a folded portion) of the pad 796. The pad canbe, for example, a pad with two sides (e.g., a pad first side 796 a anda pad second side 796 b) that can be connected by the living hinge 797.As another example, the loader control suture holder 795 can have twopads connected by a living hinge. The two pads and the living hinge canbe, for example, a single pad (e.g., pad 796) folded over on itself asshown in FIG. 19A. The fold in the pad 796 can be the living hinge 797.The suture 70 can pass between the two pads of the loader control sutureholder, or can pass between the two sides (e.g., the pad first andsecond sides 796 a, 796 b) of a single pad of the loader control sutureholder 795. When the loader control first side 762 _(FS) and the loadercontrol second side 762 _(SS) are pressed together, the pad 796 of theloader control suture holder 795 can clamp the suture 70 in the loadercontrol 762, inhibiting or preventing the suture 70 from slippingthrough the loader control 762 until the loader control threshold forceis reached or exceeded as the loader control 762 is moved from theloader control first position to the loader control second position. Thesuture 70 can slip through the loader control suture holder 795, forexample, as the loader control 762 is moved from a fully loaded positionto an overloaded position. For example, the suture 70 can slip throughthe loader control suture holder 795 as the loader control 762 is movedfrom the loader control second position to the loader control thirdposition. The threshold force can be, for example, from about 2.00 lbsto about 10.00 lbs, including every 0.01 lb increment within this range(e.g., 2.00 lbs, 3.00 lbs, 6.00 lbs, 10.00 lbs). The threshold force canbe higher than the loading force needed for loading the shuttle 14 intothe device 188. For example, the loading force can be about 0.30 lbs toabout 4.00 lbs, including every 0.01 lb increment within this range(e.g., 0.30 lbs, 0.50 lbs, 2.00 lbs, 4.00 lbs).

FIG. 19A further illustrates that a first half of the loader controlfirst side 762 _(FS) can be lifted in direction 798 to open the loadercontrol suture holder 795. When the loader control suture holder 795 isopened, the first half of the loader control first side 762 _(FS) canrotate about the living hinge 797 away from a second half of the loadercontrol first side 762 _(FS). The loader control suture holder 795 canbe opened, for example, to load the loader control 762 with the suture70, to remove the suture 70 from the loader control 762 (e.g., after theshuttle 14 is fully loaded into the device), or both.

FIG. 19A further illustrates that the loader control 762 can have aloader control connector 762 c that can connect the loader control firstand second sides 762 _(FS), 762 _(SS), and which can extend through thetrack 764.

FIG. 19B illustrates that the suture 70 can be extend though the throughthe loader control suture holder 795. For example, 19B illustrates thatthe suture 70 can extend transversely through the loader control sutureholder 795 between the pad first side 796 a and the pad second side 796b.

The loader control suture holder 795 can hold the suture 70 and/or thesuture 70 can slip through the loader control suture holder 795 withoutthe suture 70 being damaged.

The shuttle 14 can be loaded into the device 188 (e.g., into the upperjaw 30 or the lower jaw 38) using one hands or two hands. For example,two handed loading, one hand can be squeezing the jaw control 8 to clampthe jaws against the loader 750 (e.g., against the cap 758 and/oragainst the loader body 751) and the other hand can move the loadercontrol 762, for example, from the loader control first position to theloader control second position or any subsequent loader control position(e.g., to the loader control third position). For one handed loading,the device 188 can be placed in the device space 752 and the loader 750can be tilted so that gravity can cause the upper and lower jaws 30, 38to make contact with the cap 758 and/or with the loader body 751 so thatthe shuttle 14 can be loaded into the device 188. While the loader 750is tilted, one or both hands can move the loader control 762, forexample, from the loader control first position to the loader controlsecond position or any subsequent loader control position (e.g., to theloader control third position).

The loader 750 can be a single-use loader or a multiple-use loader.Where the loader 750 is a single-use loader, the loader 750 can bedisposed of after the shuttle 14 is loaded into the device 188. Wherethe loader 750 is a multiple-use loader, a new shuttle 14 can beinserted into the loader 750 (e.g., into the tracks 758 and/or 760), newsuture 70 can be attached to the shuttle 14 and extended through theloader control 762 (e.g., through the loader control suture holder 795),and/or the new suture 70 can be wound around the suture holder 766.

The device 188 can be a multiple-use device, such that one or multipleshuttles 14 can be loaded and removed from the device 188. For example,where the shuttle has a lifespan of 2 to 10 passes through tissue, theshuttle 14 can be removed from the device 188 once the lifespan of theshuttle 14 expires or after the shuttle 14 no longer adequately moves orcuts through tissue (e.g., whichever is earlier) and a new shuttle 14can be loaded into the device 188 using the same loader 750 (e.g., ifthe loader is multiple-use) or a different loader 750 (e.g., if theloader is single-use).

The handle of the device 188 in FIGS. 14B-15B, 16, and 17A is not shownfor illustrative purposes only.

When the shuttle 14 is in the shuttle first position (e.g., a shuttlenon-loaded position), the shuttle 14 can have a shuttle first radius ofcurvature. When the shuttle 14 is in the shuttle second position (e.g.,a shuttle loaded position), the shuttle 14 can have a shuttle secondradius of curvature. The shuttle first and second radius of curvaturescan be the same as or different from each other. For example, whendifferent from each other, the shuttle first radius of curvature can beless then or greater than the shuttle second radius of curvature. Forexample, FIG. 14A illustrates that when the shuttle 14 is in the shuttlefirst position, the shuttle 14 can have the shuttle first radius ofcurvature, and FIGS. 16 and 17A illustrate that when the shuttle 14 isin the shuttle second position, the shuttle 14 can have the shuttlesecond radius of curvature. FIGS. 16 and 17A further illustrate that theshuttle second radius of curvature can be less than the shuttle firstradius of curvature. For example, the shuttle second radius of curvaturecan be, for example, about 0.010 in. to about 0.075 in. less than theshuttle first radius of curvature, including every 0.001 in. incrementwithin this range (e.g., 0.010 in., 0.015 in., 0.075 in.). The shuttle14 can be a spring. For example, when the shuttle 14 has the shuttlesecond radius of curvature, the shuttle 14 can be biased to have theshuttle first radius of curvature. For example, when the shuttle 14 hasthe shuttle second radius of curvature and is in the upper jaw 30 or thelower jaw 38, the shuttle 14 can be biased to push the male stops 412outward (e.g., radially outward) into the female stops 416 when theshuttle 14 is moved (e.g., translated) into the upper jaw 30 or into thelower jaw 38 from the loader 750 (e.g., via the loader control 762). Asanother example, the shuttle 14 can have the same radius of curvature(e.g., the shuttle first radius of curvature) before and after beingloaded into the device 188. For example, the shuttle 14 can have thesame radius of curvature (e.g., the shuttle first radius of curvature)when the shuttle 14 is in the shuttle first position and when theshuttle 14 is in the shuttle second position. The loader control 762 canmove the male stops 412 into engagement with the female stops 416, forexample, by moving the loader in direction 765 (e.g., from the loadercontrol first position to the loader control second position). Asanother example, the loader control 762 can move the male stops 412 outof engagement with the female stops 416, for example, by moving theloader in a direction opposite to direction 765 (e.g., from the controlsecond position to the loader control first position), for example, ifan adjustment is desired (e.g., realign the shuttle 14 or the device 188in or on the loader 750).

The loader 750 can be used to load a suture and/or a shuttle into asuture device (e.g., a device 188). The loader 750 can have a suture(e.g., the suture 70) and/or a shuttle (e.g., the shuttle 14) that canbe moved (e.g., via a loader control 762) from a non-loadedconfiguration (e.g., FIG. 14A) to a loaded configuration (e.g., FIGS. 16and/or FIG. 17A) without damaging the suture or the shuttle, or withcausing minimal damage to the suture or the shuttle such that the sutureor the shuttle can still be used after the minimal damage is causedduring the loading the loading process.

Any of the devices (e.g., devices 188) disclosed, illustrated, and/orcontemplated herein can be removably attachable to the loader 750, forexample, to load the shuttle 14 into the device.

Any systems, devices, features, and/or methods disclosed, illustrated,and/or contemplated in U.S. application Ser. No. 14/255,945 filed Apr.17, 2014 (published as US 2014/0316443), in International ApplicationNo. PCT/US2019/025203 filed Apr. 1, 2019 (published as WO 2019/191768),and/or in U.S. application Ser. No. 16/733,740 filed Jan. 3, 2020 eachof which is herein incorporated by reference in its entirety for allpurposes—can be used with the loader 750 for any purpose (e.g., to loadany of the systems, devices, and/or features in any of theseapplications with a suture and/or with a shuttle) and/or can be combinedwith any of the systems, devices, features, and/or methods disclosed,illustrated, and/or contemplated herein for any purpose.

It is apparent to one skilled in the art that various changes andmodifications can be made to this disclosure, and equivalents employed,without departing from the spirit and scope of the disclosure. Elementsshown with any variation are exemplary for the specific variation andcan be used on other variations within this disclosure. Any elementsdescribed herein as singular can be pluralized (i.e., anything describedas “one” can be more than one). Any species element of a genus elementcan have the characteristics or elements of any other species element ofthat genus. The above-described configurations, elements or completeassemblies and methods and their elements for carrying out thedisclosure, and variations of aspects of the disclosure can be combinedand modified with each other in any combination. Any phrase involving an“A and/or B” construction or similar construction can mean (1) A alone,(2) B alone, (3) A and B together. Any range disclosed can include anysubrange of the range disclosed, for example, a range of 1-10 units caninclude 2-10 units, 8-10 units, or any other subrange.

We claim:
 1. A system disclosed herein.
 2. A device disclosed herein. 3.A method disclosed herein.